| 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 James Lipham |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1528053717 PECOS PAC ID: 5496740532 Enrollment ID: I20041013000403 |
| Provider Name | Jill M Englund |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427042019 PECOS PAC ID: 3678516937 Enrollment ID: I20050607001155 |
| 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 | 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 | Mark A Dsouza |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902153125 PECOS PAC ID: 3476706409 Enrollment ID: I20121226000317 |
| 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 | 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 | Kaitlyn Brettin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1811576713 PECOS PAC ID: 1153730882 Enrollment ID: I20250501001852 |
| Provider Name | Joshua T King |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1588234496 PECOS PAC ID: 2961804182 Enrollment ID: I20250506000178 |
| Provider Name | Brianna Johnson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568235489 PECOS PAC ID: 2062860273 Enrollment ID: I20250520000110 |
| Provider Name | Lauren Elizabeth Disterhaft |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831086057 PECOS PAC ID: 4981117892 Enrollment ID: I20250702001940 |
| Provider Name | Aneesha Ahluwalia |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1811573322 PECOS PAC ID: 7012406119 Enrollment ID: I20260331001713 |
| Provider Name | James Hunter Ellis |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1598401606 PECOS PAC ID: 6103206420 Enrollment ID: I20260508003154 |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Eye Consultants, Pa 9801 Dupont Ave S Ste 425, Bloomington, MN 55431-3873 Ph: (952) 888-5800 | Minnesota Eye Consultants, Pa 9801 Dupont Ave S, Suite 200, Bloomington, MN 55431-3100 Ph: (952) 888-5800 |