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NORTHWEST EYE CLINIC, LLC
NPI 1255417002
Ophthalmology in St. Anthony, MN

Active since October 27, 2006
2601 39TH AVE NE STE 1, ST. ANTHONY, MN 55421(763) 416-7600(763) 416-7634 Get Directions Write a Review

NPPES record last updated: March 18, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 18, 2020, Sep 5, 2019, Aug 26, 2019 and 1 more (4 updates tracked since 2019).

About Northwest Eye Clinic, Llc NPPES

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

NORTHWEST EYE CLINIC, LLC (NPI 1255417002) is a healthcare organization registered as an ophthalmology in St. Anthony, Minnesota and active in the NPI registry since October 2006. The organization lists Kelly Pettengill, Credentialing And Data Management, as its authorized official.

NPPES Registry Identity

NPI1255417002
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameNORTHWEST EYE CLINIC, LLC
Location Address2601 39TH AVE NE STE 1St. Anthony, MN 55421
Mailing Address8401 Golden Valley Rd Ste 330Golden Valley, MN 55427-4488 · (763) 416-7629 · Fax (763) 383-4147
Phone(763) 416-7600
Fax(763) 416-7634
Organization SubpartNo
Authorized OfficialKelly PettengillCredentialing And Data Management · (763) 416-7629
Enumeration DateOctober 27, 2006
Last NPPES UpdateMarch 18, 20204 updates tracked since enumeration
NPPES CertifiedMarch 18, 2020
✔ NPI 1255417002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in MN · 360
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.
2601 39TH AVE NE STE 1, St. Anthony, MN 55421
Open in Google Maps ↗

Other Identifiers 1

Medicaid298616700MN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica.Insurance ›

Other Providers at the Same Location NPPES

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

DR. DANE M PETERSON OD
Optometrist
2601 39TH AVE NE STE 1
ST. ANTHONY, MN 55421
Anoka County (763) 416-7600

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 Northwest Eye Clinic, LLC's NPI number?

The NPI number for Northwest Eye Clinic, LLC is 1255417002. It was assigned to this organization in the NPPES registry on October 27, 2006.

Where is Northwest Eye Clinic, LLC located?

Northwest Eye Clinic, LLC is located at 2601 39th Ave NE Ste 1, St. Anthony, MN 55421. The listed phone number is (763) 416-7600.

What is Northwest Eye Clinic, LLC's specialty?

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

What insurance does Northwest Eye Clinic, LLC accept?

Health plans from HealthPartners and Medica list Northwest Eye Clinic, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Northwest Eye Clinic, LLC was last updated on March 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.