NPIMap

Organization Active NPI

Edina Eye Physicians and Surgeons PA

Doing business as Twin Cities Eye Consultants

  • Medical Specialty Clinic/Center
  • Blaine, MN
National Provider Identifier
1114124971
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
EDINA EYE PHYSICIANS AND SURGEONS PA
Doing business as
Twin Cities Eye Consultants
Practice address
11855 Ulysses St
Suite 140
Blaine, MN 55434
Phone
(763) 421-7420
Fax
(763) 421-0730
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Delta Jorgensen
Title
Practice Administrator
Phone
(763) 592-8413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X MN Primary

Addresses

Primary practice location

11855 Ulysses St
Suite 140
Blaine, MN 55434

Mailing address

3777 Coon Rapids Blvd NW Ste 100
Coon Rapids, MN 55433-2630
Phone (612) 999-2020

Other names 1

  • Twin Cities Eye Consultants Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050518000059 MN Part B Supplier - Clinic/Group Practice 1355382698 Receives reassigned benefits from 24 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Waconia, MN; Shakopee, MN; Saint Paul, MN; Elk River, MN; Coon Rapids, MN; Edina, MN; Blaine, MN; Chaska, MN…

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Edina Eye Physicians and Surgeons PA8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1114124971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3777 COON RAPIDS BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332630",
            "telephone_number": "612-999-2020",
            "fax_number": "763-421-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11855 ULYSSES ST",
            "address_2": "SUITE 140",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55434",
            "telephone_number": "763-421-7420",
            "fax_number": "763-421-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDINA EYE PHYSICIANS AND SURGEONS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "JORGENSEN",
        "authorized_official_first_name": "DELTA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "763-592-8413"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twin Cities Eye Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.