MEDICARE: EYE CARE ASSOCIATES PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	74	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7D637EY	OTHER	MN	BLUE SHIELD
2	2793	OTHER	MN	HEALTHPARTNERS

General Provider Information

NPI Number	:	1205943214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE CARE ASSOCIATES PA

Provider Business Mailing Address
First Line	:	825 NICOLLET MALL
Second Line	:	SUITE 2000
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55402-2606
Country	:	US
Telephone Number	:	612-338-4861
Fax Number	:	612-333-8306

Provider Business Practice Location Address
First Line	:	4001 STINSON BLVD
Second Line	:	SUITE 100
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55421-3488
Country	:	US
Telephone Number	:	612-788-1621
Fax Number	:	612-788-8079

Authorized Official
Title or Position	:	SR PARTNER
Name	:	ROBERT WARSHAWSKY
Credential	:	MD
Telephone Number	:	612-338-4861

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	09/24/2007

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Directions to “EYE CARE ASSOCIATES PA ” Practice Location

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