Edina Eye Physicians And Surgeons Pa | |
560 S Maple St, Suite110, Waconia, MN 55387-1763 | |
(952) 442-4445 | |
(952) 832-8148 |
Full Name | Edina Eye Physicians And Surgeons Pa |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 560 S Maple St, Waconia, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538264981 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 7314104 (Minnesota) | Secondary |
207W00000X | Ophthalmology | 7314104 (Minnesota) | Primary |
Provider Name | Jeffrey J Stephens |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1508833138 PECOS PAC ID: 4880595941 Enrollment ID: I20040120000915 |
Provider Name | Bridget Axelson |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1073542767 PECOS PAC ID: 7315934791 Enrollment ID: I20040428000216 |
Provider Name | Timothy A Eggimann |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1922038926 PECOS PAC ID: 2163499781 Enrollment ID: I20040914000307 |
Provider Name | Mark C Lobanoff |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1205870045 PECOS PAC ID: 6507825437 Enrollment ID: I20041210000165 |
Provider Name | Carter J Nichols |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1366418790 PECOS PAC ID: 5698716835 Enrollment ID: I20050525000136 |
Provider Name | Scott T Schaefer |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1295843225 PECOS PAC ID: 1557383726 Enrollment ID: I20060103000064 |
Provider Name | Victor A Thonn |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1972674299 PECOS PAC ID: 0244247799 Enrollment ID: I20060308000835 |
Provider Name | Patrick K Johnson |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1710190939 PECOS PAC ID: 4688765464 Enrollment ID: I20070808000492 |
Provider Name | Kevin F Jund |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1619937471 PECOS PAC ID: 5890881288 Enrollment ID: I20071017000108 |
Provider Name | David V Folden |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1912151929 PECOS PAC ID: 8729131271 Enrollment ID: I20090730000302 |
Provider Name | Marlene M Kluss |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1891924304 PECOS PAC ID: 9133266364 Enrollment ID: I20091021000171 |
Provider Name | Eugene O Gullingsrud |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1114994589 PECOS PAC ID: 2860433000 Enrollment ID: I20100514000164 |
Provider Name | Marshall H Everson |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1548236979 PECOS PAC ID: 7214978451 Enrollment ID: I20100514000188 |
Provider Name | Suzanne R Viggiano |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1366419400 PECOS PAC ID: 2062542590 Enrollment ID: I20100610000347 |
Provider Name | Chad D Kalil |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1588790729 PECOS PAC ID: 1355367764 Enrollment ID: I20120424000707 |
Provider Name | Becky Yeung |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1568873123 PECOS PAC ID: 3476775677 Enrollment ID: I20141103001766 |
Provider Name | Amanda Mae Schmitz |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1750645115 PECOS PAC ID: 9335466960 Enrollment ID: I20150319001902 |
Provider Name | John Patrick Oneill |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1417213430 PECOS PAC ID: 8628373057 Enrollment ID: I20160413000615 |
Provider Name | Paul C Hammond |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1285918268 PECOS PAC ID: 8921308966 Enrollment ID: I20160608000634 |
Provider Name | George R Wandling |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1083935068 PECOS PAC ID: 1557587938 Enrollment ID: I20161115000674 |
Provider Name | Scott R Peterson |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1598121808 PECOS PAC ID: 6709153257 Enrollment ID: I20170605000891 |
Provider Name | Priyanka Kanakamedala |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1790104974 PECOS PAC ID: 4789990474 Enrollment ID: I20180608002352 |
Provider Name | Luke Tae Jong Moore |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1023452182 PECOS PAC ID: 1951674555 Enrollment ID: I20180727001981 |
Provider Name | Christina Anne Kuzas |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1477034171 PECOS PAC ID: 2769733930 Enrollment ID: I20180927000335 |
Provider Name | Phillip M Radke |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1407112881 PECOS PAC ID: 7416253679 Enrollment ID: I20190801000511 |
Provider Name | Margaret Shipitalo |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1760968895 PECOS PAC ID: 0941538235 Enrollment ID: I20190823002912 |
Provider Name | Andrew James Mackner |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1639646664 PECOS PAC ID: 8022349760 Enrollment ID: I20191011000380 |
Provider Name | Linda M Chous |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1205814134 PECOS PAC ID: 6800216060 Enrollment ID: I20201009001077 |
Provider Name | Ryan David Johnson |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1407380397 PECOS PAC ID: 8628489895 Enrollment ID: I20210724000059 |
Provider Name | Calvin D Boots |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1619525458 PECOS PAC ID: 9931431715 Enrollment ID: I20220120001126 |
Provider Name | Christopher D Stefonowicz |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1003345786 PECOS PAC ID: 6709158868 Enrollment ID: I20221029000104 |
Mailing Address | Practice Location Address |
---|---|
Edina Eye Physicians And Surgeons Pa 7450 France Ave S, Suite 100, Edina, MN 55435-4787 Ph: (952) 832-8100 | Edina Eye Physicians And Surgeons Pa 560 S Maple St, Suite110, Waconia, MN 55387-1763 Ph: (952) 442-4445 |