Dba: Whiting Clinic is a medicare enrolled "Ophthalmology" provider in St Louis Park, Minnesota. Their current practice location is
7415 Wayzata Blvd, St Louis Park, Minnesota. You can reach out to their office (for appointments etc.) via phone at
(952) 475-3787.
Dba: Whiting Clinic is licensed to practice in Minnesota (license number ) and it also participates in the medicare program. Dba: Whiting Clinic
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 1780696146.
Healthcare Provider's Profile
| Full Name | Dba: Whiting Clinic |
|---|
| Type | Facility |
|---|
| Speciality | Ophthalmology |
|---|
| Location | 7415 Wayzata Blvd, St Louis Park, Minnesota |
|---|
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1780696146
- Provider Enumeration Date: 08/13/2006
- Last Update Date: 11/18/2010
Medicare PECOS Information:
- PECOS PAC ID: 1759275993
- Enrollment ID: O20040210000377
Medical Identifiers
Medical identifiers for Dba: Whiting Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780696146 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (Minnesota) | Secondary |
| 207W00000X | Ophthalmology | (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.
Dba: Whiting Clinic acts as a billing entity for following providers:
| Provider Name | Jabin G Krassin |
|---|
| Provider Type | Practitioner - Ophthalmology |
|---|
| Provider Identifiers | NPI Number: 1801092960
PECOS PAC ID: 6608935648
Enrollment ID: I20081106000155 |
|---|
| Provider Name | David W Whiting |
|---|
| Provider Type | Practitioner - Ophthalmology |
|---|
| Provider Identifiers | NPI Number: 1003836479
PECOS PAC ID: 9234023482
Enrollment ID: I20081218000667 |
|---|
| Provider Name | Nathan P Langemo |
|---|
| Provider Type | Practitioner - Optometry |
|---|
| Provider Identifiers | NPI Number: 1316272495
PECOS PAC ID: 2466604400
Enrollment ID: I20121220000193 |
|---|
| Provider Name | Kasie Jean Mix |
|---|
| Provider Type | Practitioner - Optometry |
|---|
| Provider Identifiers | NPI Number: 1407109275
PECOS PAC ID: 9931410727
Enrollment ID: I20150619001796 |
|---|
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. Dba: Whiting Clinic 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 Address | Practice Location Address |
|---|
Dba: Whiting Clinic
7415 Wayzata Blvd,
St Louis Park, MN 55426-1607
Ph: (952) 475-3787 | Dba: Whiting Clinic
7415 Wayzata Blvd,
St Louis Park, MN 55426-1607
Ph: (952) 475-3787 |
Reviews and Comments