Organization Active NPI

West Metro Ophthalmology

  • Ophthalmology Physician
  • Golden Valley, MN
National Provider Identifier
1316002801
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WEST METRO OPHTHALMOLOGY
Practice address
5851 Duluth St
Suite 215
Golden Valley, MN 55422-3946
Phone
(763) 546-8422
Fax
(763) 546-8114
NPI assigned
Dec 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Authorized official

Name
Steven Jay Grosser, MDNPI 1134125859
Title
Partner
Phone
(763) 546-8422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

5851 Duluth St
Suite 215
Golden Valley, MN 55422-3946

Mailing address

5851 Duluth St
Suite 215
Golden Valley, MN 55422-3946
Phone (763) 546-8422

Other identifiers 2

IdentifierTypeStateIssuer
CS8149OtherMNRAILROAD MEDICARE
875013100MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040714000308 MN Part B Supplier - Clinic/Group Practice 8729067848 Receives reassigned benefits from 10 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Plymouth, MN; Monticello, MN; Minneapolis, MN; Golden Valley, MN; Buffalo, MN; Maple Grove, MN

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
West Metro Ophthalmology PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

5851 Duluth St
Ste 215
Minneapolis, MN 55422
Phone (763) 546-8422

15655 37th Ave N
Ste 200
Plymouth, MN 55446
Phone (763) 553-0288

Practitioners & affiliated clinicians

Practitioners 9

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": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656288000000",
    "number": "1316002801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5851 DULUTH ST",
            "address_2": "SUITE 215",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554223946",
            "telephone_number": "763-546-8422",
            "fax_number": "763-546-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5851 DULUTH ST",
            "address_2": "SUITE 215",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554223946",
            "telephone_number": "763-546-8422",
            "fax_number": "763-546-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST METRO OPHTHALMOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A",
        "authorized_official_last_name": "GROSSER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "763-546-8422",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CS8149",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "875013100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.