Individual provider Active NPI

Mona M Fahmy, OD

  • Corneal and Contact Management Optometrist
  • Bloomington, MN
National Provider Identifier
1407047566
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
3084 Issued in MN
Practice address
9801 Dupont Ave S Ste 200
Bloomington, MN 55431-3200
Phone
(528) 885-8009
Fax
(952) 567-6156
NPI assigned
Aug 5, 2007
Last updated
May 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 3084 MN Primary

Addresses

Primary practice location

9801 Dupont Ave S Ste 200
Bloomington, MN 55431-3200

Mailing address

9801 Dupont Ave S
425
Bloomington, MN 55431-3100
Phone (952) 567-6092

Other identifiers 1

IdentifierTypeStateIssuer
776473000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070919000700 MN Practitioner - Optometry 2860586005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Eye Consultants, PAGroup PAC ID 4284524539, 34 clinicians

Practice addresses (Care Compare)

9801 Dupont Ave S
Suite 200
Bloomington, MN 55431-3200
Phone (952) 888-5800

Merit-based Incentive Payment System (MIPS)

Final score
80.11 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
60.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3084MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Eye Consultants, PA Corneal and Contact Management CurrentSince Jul 10, 2007 Accepting new patients

Locations

11091 Ulysses St NE
Ste 300
Blaine, MN 55434
Phone (763) 421-9410

710 E 24th St
Ste 100
Minneapolis, MN 55404
Phone (612) 813-3600

9801 DuPont Ave S
Ste 200
Minneapolis, MN 55431

9801 DuPont Ave S
Ste 425
Minneapolis, MN 55431
Phone (952) 567-6092

10709 Wayzata Blvd
Ste 200
Minnetonka, MN 55305

12501 Whitewater Dr
Ste 310
Minnetonka, MN 55343

7125 Tamarack Rd
Ste 100
Woodbury, MN 55125

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1407047566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 DUPONT AVE S",
            "address_2": "425",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313100",
            "telephone_number": "952-567-6092",
            "fax_number": "952-884-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 DUPONT AVE S STE 200",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313200",
            "telephone_number": "528-885-8009",
            "fax_number": "952-567-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHMY",
        "first_name": "MONA",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MN",
            "license": "3084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776473000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.