NORTHWEST EYE CLINIC, LLC
NPI 1891871646
Ophthalmology in Wayzata, MN

Active since October 27, 2006
250 CENTRAL AVE N STE 107, WAYZATA, MN 55391(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: July 26, 2026.

Record update history: Mar 18, 2020, Jun 17, 2019 (2 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 1891871646) is a healthcare organization registered as an ophthalmology in Wayzata, 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

NPI1891871646
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameNORTHWEST EYE CLINIC, LLC
Location Address250 CENTRAL AVE N STE 107Wayzata, MN 55391-1207
Mailing Address8401 Golden Valley Rd Ste 330Golden Valley, MN 55427-4488 · (763) 416-7629 · Fax (763) 383-4147
Fax(763) 416-7634
Organization SubpartNo
Authorized OfficialKelly PettengillCredentialing And Data Management · (763) 416-7629
Enumeration DateOctober 27, 2006
Last NPPES UpdateMarch 18, 20202 updates tracked since enumeration
NPPES CertifiedMarch 18, 2020
NPI 1891871646 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.

250 CENTRAL AVE N STE 107, Wayzata, MN 55391

Other Identifiers 1

Medicaid607693900MN

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

Medical Equipment Supplier Medicare DMEPOS 4

Medicare supplier enrollment and the product categories Northwest Eyewear carries, from the Medicare DMEPOS supplier directory.

Northwest Eyewear

DMEPOS supplier · Wayzata, MNOperated by Distinctive Eyewear LLC

Accepts Medicare assignment

Northwest Eyewear agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20546585
Medicare Participant SinceJanuary 1, 2010
Supplier Location250 Central Ave N Ste 106Wayzata, MN 55391
Supplier Specialties
Optician

Medicare Product Categories

Ocular Prostheses
Prosthetic eyes
Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses
Conventional Contact Lenses
Prosthetic Lenses: Prosthetics Cataract Lenses
Cataract Eyeglasses
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 3

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

Ophthalmology
250 CENTRAL AVE N STE 107
WAYZATA, MN 55391
Optometrist
250 CENTRAL AVE N STE 107
WAYZATA, MN 55391
Ophthalmology
250 CENTRAL AVE N STE 107
WAYZATA, MN 55391

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 1891871646. 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 250 Central Ave N Ste 107, Wayzata, MN 55391. 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.

Does Northwest Eye Clinic, LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Northwest Eyewear accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

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 with the weekly NPPES data releases published by CMS.