OrganizationActive
Northwest Eye Clinic, LLC
NPI 1891871646 · Ophthalmology Physician · Wayzata, MN
Northwest Eye Clinic, LLC is a Ophthalmology Physician organization in Wayzata, MN (NPI 1891871646).
Provider details
- NPI number
- 1891871646
- Entity type
- Organization
- Primary specialty
- Ophthalmology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kelly Pettengill, Credentialing and Data Management(763) 416-7629
- License
- 360 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
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
250 Central Ave N Ste 107
Wayzata, MN 55391-1207
Phone: (763) 416-7600
Fax: (763) 416-7634
Street-level locationGet directions
Mailing address
8401 Golden Valley Rd Ste 330
Golden Valley, MN 55427-4488
Registry dates
- Enumerated
- 2006-10-27
- Last updated
- 2020-03-18
- Certified
- 2020-03-18
Frequently asked questions
- What is Northwest Eye Clinic, LLC's NPI number?
- Northwest Eye Clinic, LLC's National Provider Identifier (NPI) is 1891871646, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Northwest Eye Clinic, LLC?
- Northwest Eye Clinic, LLC is classified in the NPPES registry as Ophthalmology Physician (Allopathic & Osteopathic Physicians).
- Where is Northwest Eye Clinic, LLC located?
- Northwest Eye Clinic, LLC's practice location on file with NPPES is 250 Central Ave N Ste 107, Wayzata, MN 55391-1207.
- What is Northwest Eye Clinic, LLC's phone number?
- The practice phone number listed in the NPPES registry for Northwest Eye Clinic, LLC is (763) 416-7600.
- Who is the authorized official for Northwest Eye Clinic, LLC?
- The authorized official listed on Northwest Eye Clinic, LLC's NPPES record is Kelly Pettengill, Credentialing and Data Management. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Northwest Eye Clinic, LLC's NPI active?
- Yes — Northwest Eye Clinic, LLC's NPI (1891871646) is active in the NPPES registry as of the last update on 2020-03-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.