MINNESOTA EYE CONSULTANTS, PA (NPI# 1861465064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861465064 |
| Entity Type | Organization |
| Organization Name | MINNESOTA EYE CONSULTANTS, PA |
| Practice Address |
1965 11th Ave E Suite 102 Maplewood MN 55109-5167 |
| Mailing Address |
9801 Dupont Ave S Suite 425 Bloomington MN 55431-3100 |
| Practice Telephone | 9528885800 |
| Practice Fax Number | 6517484445 |
| Mailing Telephone | 9528885800 |
| Mailing Fax Number | 9525676156 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2017-02-22 |
| Authorized Official Name | BRENT L WILDE (PRESIDENT) |
| Authorized Official Telephone | 9528885800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
Eye and Vision Services Providers | ||
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| N | 291U00000X | Clinical Medical Laboratory | 24D2023181 | MN | Laboratories |
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | CLIA | 24D2023181 | 01 |
| MN | RR MEDICARE GROUP NUMBER | CG8516 | 01 |
| MN | 680090400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932173374 | Minnesota Eye Consultants, Pa | Optometrist | 10709 Wayzata Blvd, Suite 200, Minnetonka, MN 55305-5509 | 2006-02-14 |
| 1326019829 | Minnesota Eye Consultants, Pa | Eyewear Supplier (Equipment, not the service) | 9801 Dupont Ave South, Suite 200, Bloomington, MN 55431-3180 | 2006-02-01 |
| 1467815357 | Minnesota Eye Consultants, Pa | Optometrist | 1347 Larpenteur Ave W, Falcon Heights, MN 55113-6302 | 2016-03-30 |
| 1104146265 | Minnesota Eye Consultants, Pa | Clinical Medical Laboratory | 11091 Ulysses St Ne, Suite 300, Blaine, MN 55434-4237 | 2010-06-10 |
| 1952452674 | Minnesota Eye Consultants, Pa | Optometrist | 9801 Dupont Ave S, Suite 200, Bloomington, MN 55431-3100 | 2007-01-16 |
| 1205930542 | Minnesota Eye Consultants, Pa | Optometrist | 9801 Dupont Ave S, Suite 425, Bloomington, MN 55431-3100 | 2006-09-08 |
| 1174596399 | Minnesota Eye Consultants, Pa | Ophthalmology | 710 E 24th St, Suite 103, Minneapolis, MN 55404-3840 | 2006-02-08 |
| 1508839879 | Minnesota Eye Consultants, Pa | Optometrist | 9801 Dupont Ave S, Suite 200, Bloomington, MN 55431-3100 | 2006-02-08 |
| 1477526747 | Minnesota Eye Consultants, Pa | Optometrist | 710 E 24th St, Suite 100, Minneapolis, MN 55404-3840 | 2006-02-08 |
| Street Address |
1965 11TH AVE E SUITE 102 |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-5167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033473343 | Ashley Herde | Optometrist | 1965 11th Ave E, Suite 101, Maplewood, MN 55109-5167 | 2012-07-02 |
| 1730203597 | Optometric Eye Care Centers, Pa | Optometrist | 1965 11th Ave E, Suite 101, Maplewood, MN 55109-5167 | 2007-03-19 |
| 1922058247 | Bradley D Richter | Optometrist | 1965 11th Ave E, Maplewood, MN 55109-5167 | 2006-05-10 |
| 1407806763 | Mitchell H Albers | Optometrist | 1965 11th Ave E, Maplewood, MN 55109-5167 | 2006-05-10 |
| 1326096686 | Gregory W Kraupa | Optometrist | 1965 11th Ave E, Maplewood, MN 55109-5167 | 2006-05-05 |
| 1619957115 | Minnesota Eye Laser & Surgery Centers, LLC | Clinic/Center | 1965 11th Ave E, Maplewood, MN 55109-5167 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290486 | Eye Care Associates, Pa | Ophthalmology | 710 E 24th St Ste 101-201, Minneapolis, MN 55404-3840 | 2018-10-12 |
| 1548794316 | Trevor Kindle | Ophthalmology | 200 1st Ave Nw, Rochester, MN 55901 | 2017-04-18 |
| 1790228294 | Eye Associates of Central Minnesota Pa | Ophthalmology | 628 Roosevelt Rd, Suite 101, Saint Cloud, MN 56301-4867 | 2016-12-01 |
| 1093160491 | Christina Gillmor | Ophthalmology | 516 Delaware St Se Fl 9, Minneapolis, MN 55455-0356 | 2016-05-04 |
| 1861889776 | Michael Andrew Jordan | Ophthalmology | 825 Nicollet Mall Ste 2000, Minneapolis, MN 55402-2708 | 2015-04-17 |
| 1467872390 | Luke Dolezal | Ophthalmology | 5851 Duluth St Ste 215, Golden Valley, MN 55422-3956 | 2014-04-17 |
| 1811330939 | James Layer | Ophthalmology | 3708 Upton Ave S, Minneapolis, MN 55410-1237 | 2013-04-08 |
| 1093058158 | Hao Tang | Ophthalmology | 7760 France Ave S Ste 310, Edina, MN 55435 | 2013-03-27 |
| 1407112881 | Phillip Michael Armand Radke | Ophthalmology | 7450 France Ave S Ste 100, Edina, MN 55435-4799 | 2012-04-10 |
| 1023374964 | Sasha Strul | Ophthalmology | 701 25th Ave S Ste 300, Minneapolis, MN 55454-1443 | 2012-04-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.