Minnesota Retina Associates, LLC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

MINNESOTA RETINA ASSOCIATES, LLC

Practice address

9801 Dupont Ave S Ste 110
Bloomington, MN 55431-3179

Phone

(612) 355-6510

NPI assigned

Mar 17, 2022

Organization subpart

No

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

Authorized official

Name

Clifton Chad Bazhaw

Title

Sr Vice President Revenue Cycle

Phone

(469) 270-6658

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: mroozbahani@uvpmra.intellechartdirect.net
• Direct secure messaging: mfeldmann@uvpmra.intellechartdirect.net
• Direct secure messaging: hnazari@uvpmra.intellechartdirect.net

Practitioners 5

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

• Marni G Feldmann, MD

  • Retina Specialist (Ophthalmology) Physician
  • Golden Valley, MN
  • NPI 1730138595
  Medicare reassignment Care Compare group NPD
• Hossein Khanamiri Nazari, MD

  • Retina Specialist (Ophthalmology) Physician
  • Minneapolis, MN
  • NPI 1619355617
  Medicare reassignment Care Compare group NPD
• Mehdi Roozbahani, MD

  • Retina Specialist (Ophthalmology) Physician
  • Bloomington, MN
  • NPI 1093332041
  Medicare reassignment Care Compare group NPD
• Aigerim B. Saulebayeva, M.D.

  • Ophthalmology Physician
  • Hutchinson, MN
  • NPI 1043744196
  Medicare reassignment Care Compare group NPD
• Thomas W Samuelson, M.D.

  • Ophthalmology Physician
  • Minnetonka, MN
  • NPI 1265427918
  NPD

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761177600000",
    "number": "1356099352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 GOLDEN VALLEY RD STE 330",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274488",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 DUPONT AVE S STE 110",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313179",
            "telephone_number": "612-355-6510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1455 Montreal St SE",
            "address_purpose": "LOCATION",
            "city": "Hutchinson",
            "state": "MN",
            "postal_code": "553503318",
            "country_code": "US",
            "telephone_number": "612-355-6510",
            "fax_number": "612-713-9360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Greeley Ave N Ste 1215",
            "address_purpose": "LOCATION",
            "city": "Glencoe",
            "state": "MN",
            "postal_code": "553362135",
            "country_code": "US",
            "telephone_number": "612-355-6510",
            "fax_number": "612-643-9630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8501 Golden Valley Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Golden Valley",
            "state": "MN",
            "postal_code": "554274472",
            "country_code": "US",
            "telephone_number": "612-355-6510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINNESOTA RETINA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-17",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A",
        "authorized_official_last_name": "BAZHAW",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "SR VICE PRESIDENT REVENUE  CYCLE",
        "authorized_official_telephone_number": "469-270-6658"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minnesota Eye Laser & Surgery Centers, LLC
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• Minnesota Masonic Home Care Center
• Minnesota Multicultural Center for Health
• Ayan Mire
• Nasteho Mire
• Thomas Michael Misukanis Sr., PH.D.
• Mitchell Olson, DDS PA
• Jennifer Mitchell, PHARM.D.

• Retina Specialist (Ophthalmology) Physician in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Retina Specialist (Ophthalmology) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.