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Contact Information

OPHTHALMOLOGY PA
3100 W 70TH ST
EDINA, MN55435-4227
 Phone: 952-848-8300
 Fax: 952-848-8313
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for OPHTHALMOLOGY PA · (Female)

NPI Number 1114921996
Status Active
Credentials
Entity Individual
Enumeration date 06/09/2005
Last updated 05/01/2026 - About a month ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # 0026007
  • MN Medicaid 585010000
  • MN Other 130790P BLUE SHIELD OF MINNESOTA
  • MN Other 156 HEALTH PARTNERS
  • MN Other CP4332 RAILROAD MEDICARE
  • MN Other D044 UCARE MINNESOTA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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