| Minnesota Eye Consultants, Pa | |
| 
					9801 Dupont Ave S, Suite 200, Bloomington, MN 55431-3100  | |
| (952) 888-5800 | |
| (952) 884-2656 | 
| Full Name | Minnesota Eye Consultants, Pa | 
|---|---|
| Type | Facility | 
| Speciality | Ophthalmology | 
| Location | 9801 Dupont Ave S, Bloomington, Minnesota | 
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1508839879 | NPI | - | NPPES | 
| Provider Name | Omar E Awad | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1619942174 PECOS PAC ID: 9830098755 Enrollment ID: I20040108000615  | 
| Provider Name | Ahmad M Fahmy | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1598750929 PECOS PAC ID: 9931194792 Enrollment ID: I20040420000246  | 
| Provider Name | David R Hardten | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1508851387 PECOS PAC ID: 6204726565 Enrollment ID: I20040909001392  | 
| Provider Name | Patrick J Riedel | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1962497156 PECOS PAC ID: 2860469558 Enrollment ID: I20040913000863  | 
| Provider Name | Thomas W Samuelson | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1265427918 PECOS PAC ID: 2668362922 Enrollment ID: I20041013000235  | 
| Provider Name | William J Lipham | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1528053717 PECOS PAC ID: 5496740532 Enrollment ID: I20041013000403  | 
| Provider Name | Benjamin J Fogal | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1730174822 PECOS PAC ID: 0244266856 Enrollment ID: I20050714000960  | 
| Provider Name | Sherman Winston Reeves | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1205882560 PECOS PAC ID: 1254363260 Enrollment ID: I20060509000805  | 
| Provider Name | Johnna D Hobbs | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1437224276 PECOS PAC ID: 8426050139 Enrollment ID: I20070209000165  | 
| Provider Name | Mona M Fahmy | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1407047566 PECOS PAC ID: 2860586005 Enrollment ID: I20070919000700  | 
| Provider Name | Noumia Cloutier-gill | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1457508988 PECOS PAC ID: 1850459256 Enrollment ID: I20081028000685  | 
| Provider Name | Gina M Doeden | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1558350207 PECOS PAC ID: 0547303257 Enrollment ID: I20100203000513  | 
| Provider Name | Elizabeth Davis | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1134114259 PECOS PAC ID: 8729073861 Enrollment ID: I20100504000487  | 
| Provider Name | Eugene O Gullingsrud | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1114994589 PECOS PAC ID: 2860433000 Enrollment ID: I20100514000164  | 
| Provider Name | Jill S Melicher Larson | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1285788950 PECOS PAC ID: 4587736103 Enrollment ID: I20100928001713  | 
| Provider Name | Alyson L Blakstad | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1427043660 PECOS PAC ID: 5092904441 Enrollment ID: I20110115000013  | 
| Provider Name | Tara R Barth | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1548499676 PECOS PAC ID: 7719159649 Enrollment ID: I20111018000638  | 
| Provider Name | Christine L Larsen | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1629230206 PECOS PAC ID: 4587824297 Enrollment ID: I20130717000324  | 
| Provider Name | Sonja E Iverson-hill | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1497194112 PECOS PAC ID: 6103069075 Enrollment ID: I20130823001176  | 
| Provider Name | Mark Spencer Hansen | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1467787226 PECOS PAC ID: 5092958041 Enrollment ID: I20140617001067  | 
| Provider Name | Mark Roger Buboltz | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1205249620 PECOS PAC ID: 9931323748 Enrollment ID: I20140618001231  | 
| Provider Name | Charles Joseph Kopp | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1366855629 PECOS PAC ID: 9234353889 Enrollment ID: I20140623000003  | 
| Provider Name | Clara Choo | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1760746028 PECOS PAC ID: 5597055848 Enrollment ID: I20160527001624  | 
| Provider Name | Krista Stewart | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1295077444 PECOS PAC ID: 2567767965 Enrollment ID: I20170612002934  | 
| Provider Name | Cristelle Elise Boots | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1699323162 PECOS PAC ID: 2668704446 Enrollment ID: I20210405001681  | 
| Provider Name | Chase A Liaboe | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1992237952 PECOS PAC ID: 8224386289 Enrollment ID: I20210601002149  | 
| Provider Name | Lorin C Larson | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1134702376 PECOS PAC ID: 6507268315 Enrollment ID: I20210715001253  | 
| Provider Name | Nicole Marie Bergman | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1275272593 PECOS PAC ID: 9638558968 Enrollment ID: I20220616002302  | 
| Provider Name | Karina Marie Bement | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1952091654 PECOS PAC ID: 5991164592 Enrollment ID: I20230629002036  | 
| Provider Name | Kiersten Renee Snyder | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1972122067 PECOS PAC ID: 3173965605 Enrollment ID: I20240529001639  | 
| Provider Name | Chad Michael Serels | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1760010656 PECOS PAC ID: 5799106860 Enrollment ID: I20240605002335  | 
| Provider Name | Patrick Schultz | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1801642848 PECOS PAC ID: 5799228441 Enrollment ID: I20240621003125  | 
| Provider Name | Katherine E Simko | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1306681192 PECOS PAC ID: 7810432218 Enrollment ID: I20240710000988  | 
| Provider Name | Kaitlyn Brettin | 
|---|---|
| Provider Type | Practitioner - Ophthalmology | 
| Provider Identifiers | NPI Number: 1811576713 PECOS PAC ID: 1153730882 Enrollment ID: I20250501001852  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Minnesota Eye Consultants, Pa 9801 Dupont Ave S, Suite 425, Bloomington, MN 55431-3100 Ph: (952) 888-5800  | Minnesota Eye Consultants, Pa 9801 Dupont Ave S, Suite 200, Bloomington, MN 55431-3100 Ph: (952) 888-5800  |