NPIMap

Organization Active NPI

Northwest Eye Clinic, LLC

  • Ophthalmology Physician
  • Golden Valley, MN
National Provider Identifier
1497837306
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
360 Issued in MN
Legal business name
NORTHWEST EYE CLINIC, LLC
Practice address
8501 Golden Valley Rd Ste 100
Golden Valley, MN 55427-4472
Phone
(763) 416-7600
Fax
(763) 416-7634
NPI assigned
Oct 19, 2006
Last updated
May 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Authorized official

Name
Clifton Chad Bazhaw
Title
Chief Revenue Officer
Phone
(214) 893-0471

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 360 MN Primary
Glaucoma Specialist (Ophthalmology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207WX0009X
Retina Specialist (Ophthalmology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207WX0107X
Neuro-ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207WX0109X
Pediatric Ophthalmology and Strabismus Specialist PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207WX0110X
Cornea and External Diseases Specialist PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207WX0120X
Ophthalmic Plastic and Reconstructive Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207WX0200X

Addresses

Primary practice location

8501 Golden Valley Rd Ste 100
Golden Valley, MN 55427-4472

Mailing address

8401 Golden Valley Rd Ste 330
Golden Valley, MN 55427-4488
Phone (763) 416-7629

Other practice location 1

12501 Whitewater Dr Ste 110
Minnetonka, MN 55343-9436
Phone (763) 416-7600

Other practice location 2

1903 Wayzata Blvd Ste 110
Wayzata, MN 55391-2047
Phone (763) 416-7600

Other practice location 3

250 Central Ave N Ste 105
Wayzata, MN 55391-1207
Phone (763) 416-7600

Other practice location 4

8501 Golden Valley Rd Ste 210
Golden Valley, MN 55427-4472
Phone (763) 416-7600

Other practice location 5

250 Central Ave N Ste 107
Wayzata, MN 55391-1207
Phone (763) 416-7600

Other practice location 6

12000 Elm Creek Blvd N Ste 100
Maple Grove, MN 55369-7074
Phone (763) 416-7600

Other practice location 7

7125 Tamarack Rd Ste 150
Woodbury, MN 55125-1316
Phone (763) 416-7600

Other practice location 8

2601 39th Ave NE Ste 1
St. Anthony, MN 55421
Phone (763) 416-7600

Other practice location 9

250 Central Ave N Ste 107
Wayzata, MN 55391-1207
Phone (763) 416-7600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000843 MN Part B Supplier - Clinic/Group Practice 2163315045 Receives reassigned benefits from 22 practitioners
7 other NPIs on this enrollment
Practice locations: Saint Anthony, MN; Woodbury, MN; Wayzata, MN; St Anthony, MN; Minnetonka, MN; Maple Grove, MN; Golden Valley, MN

Other NPIs on the same Medicare enrollment 7

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
24D2288569Northwest Eye Clinic, LLC12501 Whitewater Dr Ste 110, Minnetonka, MN 55343Certificate of waiverAug 27, 2027

National Provider Directory

National Provider Directory

Locations

8501 Golden Valley Rd
Golden Valley, MN 55427

9801 DuPont Ave S
Ste 200
Minneapolis, MN 55431

12501 Whitewater Dr
Ste 110
Minnetonka, MN 55343

10709 Wayzata Blvd
Ste 100
Minnetonka, MN 55305
Phone (763) 553-1142

1903 Wayzata Blvd
Ste 110
Wayzata, MN 55391

250 Central Ave N
Ste 107
Wayzata, MN 55391

Interoperability endpoints

  • Direct secure messaging: ichinwuba@uvpnec.intellechartdirect.net
  • Direct secure messaging: tglaser@uvpnec.intellechartdirect.net
  • Direct secure messaging: kfossum@uvpnec.intellechartdirect.net
  • Direct secure messaging: eellingson@uvpnec.intellechartdirect.net
  • Direct secure messaging: coriglieri@uvpnec.intellechartdirect.net
  • Direct secure messaging: krahmatnejad@uvpnec.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1497837306",
    "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": "763-416-7629",
            "fax_number": "763-383-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 GOLDEN VALLEY RD STE 100",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274472",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12501 Whitewater Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553439436",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1903 Wayzata Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Wayzata",
            "state": "MN",
            "postal_code": "553912047",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Central Ave N Ste 105",
            "address_purpose": "LOCATION",
            "city": "Wayzata",
            "state": "MN",
            "postal_code": "553911207",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8501 Golden Valley Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Golden Valley",
            "state": "MN",
            "postal_code": "554274472",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Central Ave N Ste 107",
            "address_purpose": "LOCATION",
            "city": "Wayzata",
            "state": "MN",
            "postal_code": "553911207",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12000 Elm Creek Blvd N Ste 100",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553697074",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7125 Tamarack Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551251316",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 39th Ave NE Ste 1",
            "address_purpose": "LOCATION",
            "city": "St. Anthony",
            "state": "MN",
            "postal_code": "55421",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Central Ave N Ste 107",
            "address_purpose": "LOCATION",
            "city": "Wayzata",
            "state": "MN",
            "postal_code": "553911207",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHWEST EYE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "BAZHAW",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "CHIEF REVENUE OFFICER",
        "authorized_official_telephone_number": "214-893-0471"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "360",
            "primary": true
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0109X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0120X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 May 18, 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.