Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ophthalmology PA

Organization Ophthalmology Physician · NPI 1114921996

Ophthalmology PA is an Ophthalmology Physician in Edina, Minnesota. Licensed in Minnesota. Registered with an NPI since 2005.

Licensed in
MN
In the registry since
2005
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3100 W 70th St
Edina, MN 55435-4227
Phone: (952) 848-8300
Fax: (952) 848-8313
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence 0026007 (MN)
Eyewear Supplier Taxonomy 332H00000X · Licence 0026007 (MN)

Record details

NPI number1114921996
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jessica Berg — Business Office · (952) 848-8383
Other names McCannel Eye Clinic
NPI enumeratedJune 9, 2005
Last updated in NPPESMay 1, 2026
Certification dateMay 1, 2026
Mailing address3100 W 70th St, Edina, MN 55435-4227

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