Provider Demographics
NPI:1710906979
Name:EYE CARE ASSOCIATES PA
Entity Type:Organization
Organization Name:EYE CARE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:WARSHAWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-338-4861
Mailing Address - Street 1:825 NICOLLET MALL
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2606
Mailing Address - Country:US
Mailing Address - Phone:612-338-4861
Mailing Address - Fax:612-333-8306
Practice Address - Street 1:825 NICOLLET MALL
Practice Address - Street 2:SUITE 2000
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2606
Practice Address - Country:US
Practice Address - Phone:612-338-4861
Practice Address - Fax:612-333-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN74207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN290210900OtherMETROPOLITAN HEALTH PLAN
MN2793OtherHEALTHPARTNERS
MN290210900Medicaid
MNC757OtherUCARE MINNESOTA
MN7D637EYOtherBLUE SHIELD
MNC01930Medicare ID - Type UnspecifiedDOWNTOWN LOCATION
MN2793OtherHEALTHPARTNERS
MNC01929Medicare ID - Type UnspecifiedNORTHEAST LOCATION
MN1021630002Medicare ID - Type UnspecifiedADMINISTAR DME-DT
MNCP8673Medicare ID - Type UnspecifiedRAILROAD MEDICARE