OrganizationActive
Columbia Park Medical Group, PA
NPI 1205933611 · Eyewear Supplier · Fridley, MN
Columbia Park Medical Group, PA is a Eyewear Supplier organization in Fridley, MN (NPI 1205933611).
Provider details
- NPI number
- 1205933611
- Entity type
- Organization
- Primary specialty
- Eyewear SupplierSuppliers
- Parent organization
- Columbia Park Medical Group
- Organization subpart
- Yes
- Authorized official
- Joen Condon, Chief Financial Officer(763) 586-5839
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6341 University Ave Ne
Fridley, MN 55432-4946
Phone: (763) 572-5718
Fax: (763) 572-0318
Street-level locationGet directions
Mailing address
6401 University Ave Ne
Fridley, MN 55432-4341
Other names (DBA / former)
- Other name
- Fridley Plaza - Eyeware
Registry dates
- Enumerated
- 2006-09-20
- Last updated
- 2007-11-13
Frequently asked questions
- What is Columbia Park Medical Group, PA's NPI number?
- Columbia Park Medical Group, PA's National Provider Identifier (NPI) is 1205933611, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Columbia Park Medical Group, PA?
- Columbia Park Medical Group, PA is classified in the NPPES registry as Eyewear Supplier (Suppliers).
- Where is Columbia Park Medical Group, PA located?
- Columbia Park Medical Group, PA's practice location on file with NPPES is 6341 University Ave Ne, Fridley, MN 55432-4946.
- What is Columbia Park Medical Group, PA's phone number?
- The practice phone number listed in the NPPES registry for Columbia Park Medical Group, PA is (763) 572-5718.
- Who is the authorized official for Columbia Park Medical Group, PA?
- The authorized official listed on Columbia Park Medical Group, PA's NPPES record is Joen Condon, Chief Financial Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Columbia Park Medical Group, PA's NPI active?
- Yes — Columbia Park Medical Group, PA's NPI (1205933611) is active in the NPPES registry as of the last update on 2007-11-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.