NPIMap

Organization Active NPI

West Metro Ophthalmology, PA

  • Ophthalmology Physician
  • Buffalo, MN
National Provider Identifier
1952442790
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WEST METRO OPHTHALMOLOGY, PA
Practice address
107 Center Dr Ste 200
Buffalo, MN 55313-2963
Phone
(763) 682-9241
NPI assigned
Feb 12, 2007
Last updated
Feb 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Authorized official

Name
Steven J 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 Physician 207W00000X Primary

Addresses

Primary practice location

107 Center Dr Ste 200
Buffalo, MN 55313-2963

Mailing address

107 Center Dr Ste 200
Buffalo, MN 55313-2963
Phone (763) 682-9241

Other identifiers 2

IdentifierTypeStateIssuer
875013100MedicaidMN
CS8149OtherMNRAILROAD MEDICARE

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

504 Pine St
Monticello, MN 55362
Phone (763) 295-0004

2855 Campus Dr
Ste 520
Plymouth, MN 55441
Phone (612) 930-1111

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1952442790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CENTER DR STE 200",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132963",
            "telephone_number": "763-682-9241",
            "fax_number": "763-684-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CENTER DR STE 200",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132963",
            "telephone_number": "763-682-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST METRO OPHTHALMOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "GROSSER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "763-546-8422",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "875013100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CS8149",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.