NORTHWEST EYEWEAR
NPI 1154403723
Eyewear Supplier in Golden Valley, MN

NPI Status: Active since October 20, 2006

Contact Information

8501 GOLDEN VALLEY RD STE 100
GOLDEN VALLEY, MN
ZIP 55427
Phone: (763) 416-7655
Fax: (763) 416-7634

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Group Taxonomy
Secondary Locations
Authorized Official
Medical Equipment Supplier
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Eyewear Supplier
Medicare Supplier
Accepts Medicare Approved Payment

About NORTHWEST EYEWEAR

This page provides the complete NPI Profile along with additional information for Northwest Eyewear, a provider established in Golden Valley, Minnesota operating as a Eyewear Supplier. The healthcare provider is registered in the NPI registry with number 1154403723 assigned on October 2006. The practitioner's primary taxonomy code is 332H00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Northwest Eyewear. The authorized official of this NPI record is Kelly Pettengill (Credentialing And Data Management)

NPI: 1154403723
Provider Legal Name: DISTINCTIVE EYEWEAR, LLC
Other Organization Name: NORTHWEST EYEWEAR
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 8501 GOLDEN VALLEY RD STE 100 GOLDEN VALLEY, MN 55427
Location Phone: (763) 416-7655
Location Fax: (763) 416-7634
Mailing Address: 8401 GOLDEN VALLEY RD STE 330 GOLDEN VALLEY, MN 55427
Mailing Phone: (763) 416-7629
Mailing Fax: (763) 416-7634
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 10-20-2006
Last Update Date: 03-19-2020
Code Navigator

Northwest Eyewear is a medicare supplier with PTAN 20546759 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Conventional Contact Lenses.

Location Map

Secondary Locations

12000 Elm Creek Blvd N Ste 100
Maple Grove, MN 55369
(763) 416-7653
6060 Clearwater Dr Ste 150
Minnetonka, MN 55343
(763) 416-7656
2601 39th Ave NE Ste 1
St. Anthony, MN 55421
(763) 416-7674
250 Central Ave N Ste 106
Wayzata, MN 55391
(763) 416-7654

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: Eyewear Supplier
Taxonomy Code: 332H00000X
Type: Suppliers
Taxonomy Description: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

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)
1	156FX1800X	Eye and Vision Services Providers	Technician/Technologist Optician

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

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: KELLY PETTENGILL
Authorized Official Title: CREDENTIALING AND DATA MANAGEMENT
Authorized Official Phone: (763) 416-7629

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN: 20546759
Accepts Medicare Assignment: YES
Specialities List: Optician.
Competitive Bidding: NO

Supplies List

Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	1	5	4	4	0	3	7	2	3
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	1	10	4	8	0	6	7	4
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 0 + 4 + 8 + 0 + 6 + 7 + 4 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 3									3

The NPI number 1154403723 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.