Ophthalmology PA
NPI 1114921996ActiveOrganization· Ophthalmology· Edina, MN
Ophthalmology in Edina, Minnesota, registered in NPPES in June 2005. The authorized official on file is Jessica Louise Berg, Business Office. Enrolled in Medicare as dme supplier - physician - ophthalmology and part b supplier - clinic/group practice.
Overview
| NPI | 1114921996 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 9, 2005 |
| Last updated in NPPES | May 1, 2026 |
| Certified by provider | May 1, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Ophthalmology Primary | 207W00000X | 0026007 | MN |
| Eyewear Supplier (Equipment, not the service) | 332H00000X | 0026007 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Ophthalmology (MN); Part B Supplier - Clinic/Group Practice (MN) |
|---|
Other Ophthalmology providers in Edina
- 1477644490
- 1851717136
- 1609103209
- 1376747808
- 1902880461
- 1568880755
- 1457584336
- 1790370906
- 1891783965
- 1962440610
- 1386612364
- 1275929259