Gregory Clark, O.d., Inc. - Medicare Optometrist in Coon Rapids, MN

Gregory Clark, O.d., Inc. is a medicare enrolled "Optometrist" provider in Coon Rapids, Minnesota. Their current practice location is 12547 Riverdale Blvd Nw, Costco Optical Department, Coon Rapids, Minnesota. You can reach out to their office (for appointments etc.) via phone at (763) 712-7761.

Gregory Clark, O.d., Inc. is licensed to practice in Minnesota (license number 2806) and it also participates in the medicare program. Gregory Clark, O.d., Inc. is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1801965504.

Contact Information

Gregory Clark, O.d., Inc.
12547 Riverdale Blvd Nw, Costco Optical Department,
Coon Rapids, MN 55448-6708
(763) 712-7761
(763) 712-7787



Healthcare Provider's Profile

Full NameGregory Clark, O.d., Inc.
TypeFacility
SpecialityOptometrist
Location12547 Riverdale Blvd Nw, Coon Rapids, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1801965504
  • Provider Enumeration Date: 11/07/2006
  • Last Update Date: 11/29/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 5799880142
  • Enrollment ID: O20070413000415

Medical Identifiers

Medical identifiers for Gregory Clark, O.d., Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1801965504NPI-NPPES
1634747-00MedicaidMN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 2806 (Minnesota)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Gregory Clark, O.d., Inc. acts as a billing entity for following providers:
Provider NameJason J Stensos
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1205844966
PECOS PAC ID: 8325078322
Enrollment ID: I20050819000023

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Provider NameGregory A Clark
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1467521153
PECOS PAC ID: 8426153867
Enrollment ID: I20070413000410

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gregory Clark, O.d., Inc. is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Gregory Clark, O.d., Inc.
16160 22nd Pl N,
Plymouth, MN 55447-2382

Ph: (612) 703-0298
Gregory Clark, O.d., Inc.
12547 Riverdale Blvd Nw, Costco Optical Department,
Coon Rapids, MN 55448-6708

Ph: (763) 712-7761

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› Verified 9 days ago


Optometrist in Coon Rapids, MN

Dr. Kristi Jo Backer Palmer, O.D.
Optometrist
Medicare: Accepting Medicare Assignments
Practice Location: 9055 Springbrook Dr Nw, Coon Rapids, MN 55433
Phone: 763-780-9155    
Dr. Bridget C Axelson, O.D.
Optometrist
Medicare: Accepting Medicare Assignments
Practice Location: 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433
Phone: 763-421-7420    
Robert Dodge, O.D.
Optometrist
Medicare: Medicare Enrolled
Practice Location: 12737 Riverdale Blvd Nw, Coon Rapids, MN 55448
Phone: 763-433-3468    
Nordin Eye Care Associates Inc
Optometrist
Medicare: Not Enrolled in Medicare
Practice Location: 13020 Riverdale Dr Nw, Coon Rapids, MN 55448
Phone: 763-421-9652    
James Conrad Verkuilen, OD
Optometrist
Medicare: Accepting Medicare Assignments
Practice Location: 9055 Springbrook Dr Nw, Coon Rapids, MN 55433
Phone: 763-780-9155    
Vista Family Eye Care Llc
Optometrist
Medicare: Not Enrolled in Medicare
Practice Location: 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433
Phone: 763-843-7153    
Dr. Paul Chadima Hammond, O.D.
Optometrist
Medicare: Accepting Medicare Assignments
Practice Location: 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433
Phone: 763-421-7420    

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