MINNESOTA RETINA ASSOCIATES, LLC
NPI 1356099352
Ophthalmology - Retina Specialist in Bloomington, MN
About Minnesota Retina Associates, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MINNESOTA RETINA ASSOCIATES, LLC (NPI 1356099352) is a healthcare organization registered as a retina specialist in Bloomington, Minnesota and active in the NPI registry since March 2022. The organization maintains 3 additional practice locations and lists Clifton Chad Bazhaw, Sr Vice President Revenue Cycle, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Minnesota Retina Associates, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Minnesota Retina Associates, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Retina Associates, LLC's NPI number?
The NPI number for Minnesota Retina Associates, LLC is 1356099352. It was assigned to this organization in the NPPES registry on March 17, 2022.
Where is Minnesota Retina Associates, LLC located?
Minnesota Retina Associates, LLC is located at 9801 Dupont Ave S Ste 110, Bloomington, MN 55431. The listed phone number is (612) 355-6510.
What is Minnesota Retina Associates, LLC's specialty?
The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.
Is Minnesota Retina Associates, LLC enrolled in Medicare?
Yes. Minnesota Retina Associates, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Minnesota Retina Associates, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Ophthalmology, reassign their Medicare billing to Minnesota Retina Associates, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Minnesota Retina Associates, LLC was last updated on October 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.
# Minnesota Retina Associates, Llc · NPI 1356099352
Retina Specialist organization in Bloomington, Minnesota. Organization record, active in the CMS NPPES registry since March 17, 2022.
## Identity
- **NPI:** 1356099352 (Entity type: Organization)
- **Enumerated:** March 17, 2022
- **Primary specialty:** Ophthalmology - Retina Specialist · taxonomy 207WX0107X
- **Organization subpart:** No
- **Authorized official:** Clifton Bazhaw, SR VICE PRESIDENT REVENUE CYCLE
## Practice location
- **Address:** 9801 DUPONT AVE S STE 110, Bloomington, MN 55431-3179
- **Phone:** (612) 355-6510
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians (Ophthalmology) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 23, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1356099352) · Data from the CMS NPPES public registry.