EDINA EYE PHYSICIANS AND SURGEONS PA
NPI 1114124971
Clinic/Center - Medical Specialty in Blaine, MN
- Organization
- Clinic/Center
- Medical Specialty
- Accepts Insurance
- CLIA Number: 24D1071778
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-13-2028
About EDINA EYE PHYSICIANS AND SURGEONS PA
This page provides the complete NPI Profile along with additional information for Edina Eye Physicians And Surgeons Pa, a provider established in Blaine, Minnesota operating as a Clinic/center, focusing in medical specialty . The healthcare provider is registered in the NPI registry with number 1114124971 assigned on June 2007. The practitioner's primary taxonomy code is 261QM2500X. The provider is registered as an organization and their NPI record was last updated January 2026. The authorized official of this NPI record is Delta Jorgensen (Practice Administrator)
- NPI
- 1114124971 Verify this NPI
- Provider Name
- EDINA EYE PHYSICIANS AND SURGEONS PA
- Entity Type
- Organization
- Location Address
- 11855 ULYSSES ST SUITE 140 BLAINE, MN 55434
- Location Phone
- (763) 421-7420
- Location Fax
- (763) 421-0730
- Mailing Address
- 3777 COON RAPIDS BLVD NW STE 100 COON RAPIDS, MN 55433
- Mailing Phone
- (612) 999-2020
- Mailing Fax
- (763) 421-0730
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-27-2007
- Last Update Date
- 01-28-2026
- Code Navigator
Location Map
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
Clinic/Center Medical Specialty
- Taxonomy Code
- 261QM2500X
- Type
- Ambulatory Health Care Facilities
- License State
- MN
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Atlas $1,300 Gold - PPO
- Atlas $2,000 Standard Gold - PPO
- Atlas $3,050 Plus Silver - PPO
- Atlas $3,800 HSA Silver - PPO
- Atlas $6,000 Standard Silver - PPO
- Atlas $6,800 Plus Bronze HSA - PPO
- Atlas $7,500 Standard Bronze HSA - PPO
- Atlas $8,400 HSA Bronze - PPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 24D1071778
- Facility Type
- Physician Office
- Certificate Effective Date
- January 14, 2026
- Certificate Expiration Date
- January 13, 2028
- Laboratory Director
- JEFFERY J. STEPHENS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Edina Eye Physicians And Surgeons 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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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114124971, enumerated as an "organization" on June 27, 2007.
The provider is located at 11855 ULYSSES ST SUITE 140 BLAINE, MN 55434 and the phone number is (763) 421-7420.
Clinic/Center with taxonomy code 261QM2500X and a focus in Medical Specialty.
The provider might be accepting Accepts: HealthPartners and Medica. Please consult your insurance carrier or call the provider to verify.
