Carly Marie Grant, is a medicare enrolled "Dermatology" physician in Bloomington, Minnesota. Her current practice location is
8170 33rd Ave S, Bloomington, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(952) 883-6000.
Carly Marie Grant is licensed to practice in Minnesota (license number 35680) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1275237208.
Physician's Profile
Full Name | Carly Marie Grant |
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Gender | Female |
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Speciality | Dermatology |
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Location | 8170 33rd Ave S, Bloomington, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1275237208
- Provider Enumeration Date: 03/27/2023
- Last Update Date: 05/22/2025
Medicare PECOS Information:
- PECOS PAC ID: 6608220710
- Enrollment ID: I20230922003037
Medical Identifiers
Medical identifiers for Carly Marie Grant such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1275237208 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207N00000X | Dermatology | 35680 (Minnesota) | Primary |
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. Carly Marie Grant 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 |
Carly Marie Grant, 8170 33rd Ave S, Bloomington, MN 55425-4516 Ph: () - | Carly Marie Grant, 8170 33rd Ave S, Bloomington, MN 55425-4516 Ph: (952) 883-6000 |
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