| Edina Eye Physicians And Surgeons Pa | |
|
560 S Maple St, Suite110, Waconia, MN 55387-1763 | |
| (952) 442-4445 | |
| (952) 832-8148 |
| Full Name | Edina Eye Physicians And Surgeons Pa |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 560 S Maple St, Waconia, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538264981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 7314104 (Minnesota) | Secondary |
| 207W00000X | Ophthalmology | 7314104 (Minnesota) | Primary |
| Provider Name | Jeffrey J Stephens |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1508833138 PECOS PAC ID: 4880595941 Enrollment ID: I20040120000915 |
| Provider Name | Bridget Axelson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073542767 PECOS PAC ID: 7315934791 Enrollment ID: I20040428000216 |
| Provider Name | Timothy A Eggimann |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922038926 PECOS PAC ID: 2163499781 Enrollment ID: I20040914000307 |
| Provider Name | Mark C Lobanoff |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1205870045 PECOS PAC ID: 6507825437 Enrollment ID: I20041210000165 |
| Provider Name | Carter J Nichols |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1366418790 PECOS PAC ID: 5698716835 Enrollment ID: I20050525000136 |
| Provider Name | Scott T Schaefer |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1295843225 PECOS PAC ID: 1557383726 Enrollment ID: I20060103000064 |
| Provider Name | Victor A Thonn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972674299 PECOS PAC ID: 0244247799 Enrollment ID: I20060308000835 |
| Provider Name | Patrick K Johnson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1710190939 PECOS PAC ID: 4688765464 Enrollment ID: I20070808000492 |
| Provider Name | Kevin F Jund |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619937471 PECOS PAC ID: 5890881288 Enrollment ID: I20071017000108 |
| Provider Name | David V Folden |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1912151929 PECOS PAC ID: 8729131271 Enrollment ID: I20090730000302 |
| Provider Name | Marlene M Kluss |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891924304 PECOS PAC ID: 9133266364 Enrollment ID: I20091021000171 |
| Provider Name | Eugene O Gullingsrud |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1114994589 PECOS PAC ID: 2860433000 Enrollment ID: I20100514000164 |
| Provider Name | Marshall H Everson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1548236979 PECOS PAC ID: 7214978451 Enrollment ID: I20100514000188 |
| Provider Name | Suzanne R Viggiano |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1366419400 PECOS PAC ID: 2062542590 Enrollment ID: I20100610000347 |
| Provider Name | Chad D Kalil |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588790729 PECOS PAC ID: 1355367764 Enrollment ID: I20120424000707 |
| Provider Name | Becky Yeung |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568873123 PECOS PAC ID: 3476775677 Enrollment ID: I20141103001766 |
| Provider Name | Amanda Mae Schmitz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750645115 PECOS PAC ID: 9335466960 Enrollment ID: I20150319001902 |
| Provider Name | John Patrick Oneill |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1417213430 PECOS PAC ID: 8628373057 Enrollment ID: I20160413000615 |
| Provider Name | Paul C Hammond |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285918268 PECOS PAC ID: 8921308966 Enrollment ID: I20160608000634 |
| Provider Name | George R Wandling |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1083935068 PECOS PAC ID: 1557587938 Enrollment ID: I20161115000674 |
| Provider Name | Scott R Peterson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1598121808 PECOS PAC ID: 6709153257 Enrollment ID: I20170605000891 |
| Provider Name | Priyanka Kanakamedala |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1790104974 PECOS PAC ID: 4789990474 Enrollment ID: I20180608002352 |
| Provider Name | Luke Tae Jong Moore |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1023452182 PECOS PAC ID: 1951674555 Enrollment ID: I20180727001981 |
| Provider Name | Christina Anne Kuzas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477034171 PECOS PAC ID: 2769733930 Enrollment ID: I20180927000335 |
| Provider Name | Phillip M Radke |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1407112881 PECOS PAC ID: 7416253679 Enrollment ID: I20190801000511 |
| Provider Name | Margaret Shipitalo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760968895 PECOS PAC ID: 0941538235 Enrollment ID: I20190823002912 |
| Provider Name | Andrew James Mackner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639646664 PECOS PAC ID: 8022349760 Enrollment ID: I20191011000380 |
| Provider Name | Linda M Chous |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205814134 PECOS PAC ID: 6800216060 Enrollment ID: I20201009001077 |
| Provider Name | Ryan David Johnson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1407380397 PECOS PAC ID: 8628489895 Enrollment ID: I20210724000059 |
| Provider Name | Calvin D Boots |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619525458 PECOS PAC ID: 9931431715 Enrollment ID: I20220120001126 |
| Provider Name | Christopher D Stefonowicz |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1003345786 PECOS PAC ID: 6709158868 Enrollment ID: I20221029000104 |
| Provider Name | Matthew Garrett Field |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1962060624 PECOS PAC ID: 0941535611 Enrollment ID: I20230516001778 |
| Mailing Address | Practice Location Address |
|---|---|
| Edina Eye Physicians And Surgeons Pa 7450 France Ave S, Suite 100, Edina, MN 55435-4787 Ph: (952) 832-8100 | Edina Eye Physicians And Surgeons Pa 560 S Maple St, Suite110, Waconia, MN 55387-1763 Ph: (952) 442-4445 |