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

NPI Status: Active since June 10, 2010

Contact Information

11091 ULYSSES ST NE
SUITE 300
BLAINE, MN
ZIP 55434
Phone: (952) 888-5800
Fax: (763) 421-8297

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  • Organization
  • Ophthalmology
  • CLIA Number: 24D2300927
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-18-2028

About MINNESOTA EYE CONSULTANTS, PA

This page provides the complete NPI Profile along with additional information for Minnesota Eye Consultants, Pa, a provider established in Blaine, Minnesota operating as a Ophthalmology. The healthcare provider is registered in the NPI registry with number 1104146265 assigned on June 2010. The practitioner's primary taxonomy code is 207W00000X with license number 31920 (MN). The provider is registered as an organization and their NPI record was last updated 9 years ago. Minnesota Eye Consultants, Pa operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Brent L Wilde (President)

NPI
1104146265
Provider Name
MINNESOTA EYE CONSULTANTS, PA
Entity Type
Organization
Location Address
11091 ULYSSES ST NE SUITE 300 BLAINE, MN 55434
Location Phone
(952) 888-5800
Location Fax
(763) 421-8297
Mailing Address
9801 DUPONT AVE S SUITE 425 BLOOMINGTON, MN 55431
Mailing Phone
(952) 888-5800
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-10-2010
Last Update Date
02-22-2017
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Ophthalmologists like Minnesota Eye Consultants, Pa specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Ophthalmology

Taxonomy Code
207W00000X
Type
Allopathic & Osteopathic Physicians
License No.
31920
License State
MN
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1291U00000XLaboratories

Clinical Medical Laboratory

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

BRENT L WILDE

Authorized Official Title
PRESIDENT
Authorized Official Phone
(952) 567-6143

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
C02541MEDICARE PIN (08)MN 
24D2023184OTHER (01)MNCLIA

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D2300927
Facility Type
Physician Office
Certificate Effective Date
March 19, 2026
Certificate Expiration Date
March 18, 2028
Laboratory Director
AHMAD M. FAHMY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Minnesota Eye Consultants, Pa to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1104146265, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 45. The final step is to find the difference between that total and the next multiple of ten (50 - 45 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
1
Doubled → 2
Pos 6
4
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
2
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 1 → 2 6 → 12 → 3 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 0 + 4 + 2 + 4 + 1 + 2 + 2 + 1 + 2 + 24 = 45

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 45 is 50. The difference is the calculated check digit.

50 - 45 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1104146265.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Clinical Medical Laboratory
11091 ULYSSES ST NE, SUITE 100
BLAINE, MN 55434
Physician Assistant
11091 ULYSSES ST NE
BLAINE, MN 55434

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104146265, enumerated as an "organization" on June 10, 2010.

The provider is located at 11091 ULYSSES ST NE SUITE 300 BLAINE, MN 55434 and the phone number is (952) 888-5800.

Ophthalmology with taxonomy code 207W00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.