Jordan Kain Stidham, OD in Minneapolis, MN - Medicare Optometrist Provider

Jordan Kain Stidham, OD is a medicare enrolled "Optometrist" provider in Minneapolis, Minnesota. His current practice location is 225 Se Main St, Minneapolis, Minnesota. You can reach out to his office (for appointments etc.) via phone at (612) 379-1555.

Jordan Kain Stidham is licensed to practice in Minnesota (license number 3735) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1578016184.

Contact Information

	Jordan Kain Stidham, OD
	225 Se Main St, Minneapolis, MN 55414-2124
	(612) 379-1555
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jordan Kain Stidham
Gender	Male
Speciality	Optometrist
Location	225 Se Main St, Minneapolis, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1578016184
Provider Enumeration Date: 07/31/2016
Last Update Date: 05/29/2024

Medicare PECOS Information:

PECOS PAC ID: 7012374408
Enrollment ID: I20230530002235

Medical Identifiers

Medical identifiers for Jordan Kain Stidham such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1578016184	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	OPT.6498 (Ohio)	Secondary
152W00000X	Optometrist	3735 (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. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jordan Kain Stidham allows following entities to bill medicare on his behalf.

Provider Name	Eagan Eye Clinic Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1477732337 PECOS PAC ID: 0345220745 Enrollment ID: O20040726000300

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. Jordan Kain Stidham 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
Jordan Kain Stidham, OD 740 Main St Ste 100, Mendota Heights, MN 55118-3763 Ph: (651) 686-9393	Jordan Kain Stidham, OD 225 Se Main St, Minneapolis, MN 55414-2124 Ph: (612) 379-1555

Reviews and Comments

Optometrist in Minneapolis, MN

Nicollet Vision Care Optometrists P.a. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3142 Hennepin Ave, Minneapolis, MN 55408 Phone: 612-822-7021
The Eye Doctors Office, Pa Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4999 France Ave S, Suite 140, Minneapolis, MN 55410 Phone: 612-440-2020 Fax: 612-440-0202
Dr. Xuanmai Thi Ta, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2718 Nicollet Ave, Suite No. 103, Minneapolis, MN 55408 Phone: 612-871-1518 Fax: 612-871-2585
Dr. Theodore Lester Hansen, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 115 East Lake St, Minneapolis, MN 55408 Phone: 612-827-3857 Fax: 612-827-7204
Kari Maffitt, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3553 Hennepin Ave, Minneapolis, MN 55408 Phone: 612-822-5844 Fax: 612-827-3418
Dr. David Paul Parupsky, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1304 4th St Se, Dinkytown Optical, Minneapolis, MN 55414 Phone: 612-331-7100 Fax: 612-331-7100
Moulay Younes Elidrissi, Optometrist Medicare: Not Enrolled in Medicare Practice Location: 720 W Lake St # 107, Minneapolis, MN 55408 Phone: 612-216-4705

Jordan Kain Stidham, OD - Medicare Optometrist in Minneapolis, MN