Eye Plastic Surgery of Minnesota PLLC

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

Legal business name

EYE PLASTIC SURGERY OF MINNESOTA PLLC

Practice address

635 Bielenberg Dr Ste 220
Woodbury, MN 55125-1413

Phone

(651) 998-9048

NPI assigned

Feb 14, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Mohit Dewan, MDNPI 1851589709

Title

President

Phone

(651) 998-9048

Specialties & licenses 1

Addresses

Other names 1

• Eye Plastic Surgery of Minnesota Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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

• Mohit Alex Dewan, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Woodbury, MN
  • NPI 1851589709

  MN, Ophthalmic Plastic and Reconstructive Surgery

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1154887131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 BIELENBERG DR STE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251413",
            "telephone_number": "651-998-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BIELENBERG DR STE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251413",
            "telephone_number": "651-998-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE PLASTIC SURGERY OF MINNESOTA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "DEWAN",
        "authorized_official_first_name": "MOHIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-998-9048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Plastic Surgery of Minnesota",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Woodbury, MN
• Ophthalmic Plastic and Reconstructive Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.