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MINNESOTA EYE CONSULTANTS, PA
NPI 1104146265
Ophthalmology in Blaine, MN

Active since June 10, 2010CLIA Certified · 4 labs
11091 ULYSSES ST NE, SUITE 300, BLAINE, MN 55434(952) 888-5800(763) 421-8297 Get Directions Write a Review

NPPES record last updated: February 22, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Minnesota Eye Consultants, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MINNESOTA EYE CONSULTANTS, PA (NPI 1104146265) is a healthcare organization registered as an ophthalmology in Blaine, Minnesota and active in the NPI registry since June 2010. The organization holds 4 active CLIA laboratory certificates and lists Brent L Wilde, President, as its authorized official.

NPPES Registry Identity

NPI1104146265
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameMINNESOTA EYE CONSULTANTS, PA
Location Address11091 ULYSSES ST NE, SUITE 300Blaine, MN 55434-4237
Mailing Address9801 Dupont Ave S, Suite 425Bloomington, MN 55431-3100 · (952) 888-5800
Phone(952) 888-5800
Fax(763) 421-8297
Organization SubpartNo
Authorized OfficialBrent L WildePresident · (952) 567-6143
Enumeration DateJune 10, 2010
Last NPPES UpdateFebruary 22, 2017
✔ NPI 1104146265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in MN · 31920
Definition
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.
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
11091 ULYSSES ST NE, Blaine, MN 55434
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Other Identifiers 2

Medicare PINC02541MN
Other24D2023184MN · Clia

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2023179

Minnesota Eye Consultants PA · Bloomington, MN
Active · expires Sep 16, 2027
CLIA Number24D2023179
Laboratory TypePhysician Office
Certificate Effective DateSeptember 17, 2025
Certificate Expiration DateSeptember 16, 2027
Laboratory DirectorAhmad M. Fahmy
Laboratory Phone(952) 888-5800
Laboratory LocationMinnesota Eye Consultants PA9801 Dupont Avenue South Suite 200, Bloomington, MN 55431
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2023184

Minnesota Eye Consultants PA · Blaine, MN
Active · expires Feb 15, 2028
CLIA Number24D2023184
Laboratory TypePhysician Office
Certificate Effective DateFebruary 16, 2026
Certificate Expiration DateFebruary 15, 2028
Laboratory DirectorAhmed Fahmy
Laboratory Phone(952) 567-6130
Laboratory LocationMinnesota Eye Consultants PA11091 Ulysses Street NE Suite 300, Blaine, MN 55434
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2300927

Minnesota Eye Consultants PA · Minnetonka, MN
Active · expires Mar 18, 2028
CLIA Number24D2300927
Laboratory TypePhysician Office
Certificate Effective DateMarch 19, 2026
Certificate Expiration DateMarch 18, 2028
Laboratory DirectorAhmad M. Fahmy
Laboratory Phone(952) 888-5800
Laboratory LocationMinnesota Eye Consultants PA12501 Whitewater Dr Ste 310, Minnetonka, MN 55343
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2023185

Minnesota Eye Consultants PA · Minnetonka, MN
Active · expires Apr 17, 2027
CLIA Number24D2023185
Laboratory TypePhysician Office
Certificate Effective DateApril 18, 2025
Certificate Expiration DateApril 17, 2027
Laboratory DirectorDavid R. Hardten
Laboratory Phone(952) 888-5800
Laboratory LocationMinnesota Eye Consultants PA10709 Wayzata Blvd, Minnetonka, MN 55305
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LABORATORY CORPORATION OF AMERICA HOLDINGS
Clinical Medical Laboratory
11091 ULYSSES ST NE, SUITE 100
BLAINE, MN 55434
Anoka County (612) 879-1000
LAURA OLSON PA-C
Physician Assistant
11091 ULYSSES ST NE
BLAINE, MN 55434
Anoka County (612) 879-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Minnesota Eye Consultants, PA's NPI number?

The NPI number for Minnesota Eye Consultants, PA is 1104146265. It was assigned to this organization in the NPPES registry on June 10, 2010.

Where is Minnesota Eye Consultants, PA located?

Minnesota Eye Consultants, PA is located at 11091 Ulysses St NE Suite 300, Blaine, MN 55434. The listed phone number is (952) 888-5800.

What is Minnesota Eye Consultants, PA's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Does Minnesota Eye Consultants, PA hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Minnesota Eye Consultants, PA was last updated on February 22, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.