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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

NORTHWEST EYE CLINIC, LLC
NPI 1720982010
Eyewear Supplier in St. Anthony, MN

Active since October 08, 2026
2601 39TH AVE NE STE 1, ST. ANTHONY, MN 55421(763) 416-7600(763) 416-7634 Get Directions Write a Review

NPPES record added: October 8, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

About Northwest Eye Clinic, Llc NPPES

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

NORTHWEST EYE CLINIC, LLC (NPI 1720982010) is a healthcare organization registered as an eyewear supplier in St. Anthony, Minnesota and active in the NPI registry since October 2026. The organization lists Clifton Chad Bazhaw, Chief Revenue Officer, as its authorized official.

NPPES Registry Identity

NPI1720982010
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameNORTHWEST EYE CLINIC, LLC
Location Address2601 39TH AVE NE STE 1St. Anthony, MN 55421-4372
Mailing Address8401 Golden Valley Rd Ste 330Golden Valley, MN 55427-4687 · (763) 416-7600 · Fax (763) 416-7634
Phone(763) 416-7600
Fax(763) 416-7634
Organization SubpartNo
Authorized OfficialClifton Chad BazhawChief Revenue Officer · (214) 893-0471
Enumeration DateOctober 8, 2026
NPPES CertifiedOctober 8, 2026
✔ NPI 1720982010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
2601 39TH AVE NE STE 1, St. Anthony, MN 55421
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Other Providers at the Same Location NPPES 2

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

NORTHWEST EYE CLINIC, LLC
Ophthalmology
2601 39TH AVE NE STE 1
ST. ANTHONY, MN 55421
Anoka County (763) 416-7600
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 1720982010. It was assigned to this organization in the NPPES registry on October 8, 2026.

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 Eyewear Supplier with taxonomy code 332H00000X.

When was this NPI record last updated?

The NPPES record for Northwest Eye Clinic, LLC was last updated on October 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days 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.