NPIMap

Organization Active NPI

Edina Eye Physicians and Surgeons PA

  • Medical Specialty Clinic/Center
  • Coon Rapids, MN
National Provider Identifier
1407903248
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
Practice address
3777 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433
Phone
(763) 421-7420
Fax
(763) 421-0730
NPI assigned
Jan 4, 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
Jeffrey J Stephens
Title
Owner
Phone
(612) 999-2020

Specialties & licenses 1

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

Addresses

Primary practice location

3777 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433

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.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2120522Edina Eye Physicians and Surgeons3777 Coon Rapids Blvd NW, Suite 100, Coon Rapids, MN 55433Certificate of waiverOct 17, 2026

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.

Locations

3777 Coon Rapids Blvd NW
Ste 1
Minneapolis, MN 55433

Practitioners & affiliated clinicians

Practitioners 3

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": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1407903248",
    "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": "3777 COON RAPIDS BLVD NW",
            "address_2": "SUITE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "55433",
            "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": "2007-01-04",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-999-2020"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twin Cities Eye Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coon Rapids, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.