Dr Leroy Taylor Kincannon Iii, OD - Medicare Optometrist in Grand Rapids, MN

Dr Leroy Taylor Kincannon Iii, OD is a medicare enrolled "Optometrist" provider in Grand Rapids, Minnesota. His current practice location is 1542 Golf Course Rd, Suite 201, Grand Rapids, Minnesota. You can reach out to his office (for appointments etc.) via phone at (218) 326-3433.

Dr Leroy Taylor Kincannon Iii is licensed to practice in Minnesota (license number 2466) 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 1528173846.

Contact Information

Dr Leroy Taylor Kincannon Iii, OD
1542 Golf Course Rd, Suite 201,
Grand Rapids, MN 55744-9603
(218) 326-3433
(218) 326-3435

Map and Direction




Healthcare Provider's Profile

Full NameDr Leroy Taylor Kincannon Iii
GenderMale
SpecialityOptometrist
Location1542 Golf Course Rd, Grand Rapids, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1528173846
  • Provider Enumeration Date: 08/19/2006
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 1951364298
  • Enrollment ID: I20041108001208

Medical Identifiers

Medical identifiers for Dr Leroy Taylor Kincannon Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1528173846NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 2466 (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. Dr Leroy Taylor Kincannon Iii allows following entities to bill medicare on his behalf.
Provider NameJohn L Bonner Eye Clinic Ltd
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1053351817
PECOS PAC ID: 0547243677
Enrollment ID: O20040610000493

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. Dr Leroy Taylor Kincannon Iii 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
Dr Leroy Taylor Kincannon Iii, OD
3221 E 4th St,
Duluth, MN 55804-1831

Ph: (218) 260-8536
Dr Leroy Taylor Kincannon Iii, OD
1542 Golf Course Rd, Suite 201,
Grand Rapids, MN 55744-9603

Ph: (218) 326-3433

Reviews and Comments


Optometrist in Grand Rapids, MN

John L Bonner Eye Clinic Ltd
Optometrist
Medicare: Medicare Enrolled
Practice Location: 1542 Golf Course Rd, Suite 201, Grand Rapids, MN 55744
Phone: 218-326-3433    Fax: 218-326-3435
Heidi Dahlberg, OD
Optometrist
Medicare: Accepting Medicare Assignments
Practice Location: 100 Se 29th St, Grand Rapids, MN 55744
Phone: 218-326-1101    Fax: 218-326-1106
Paul Lee Dubbels, O.D.
Optometrist
Medicare: Accepting Medicare Assignments
Practice Location: 710 S Pokegama Ave, Grand Rapids, MN 55744
Phone: 218-326-1775    Fax: 218-326-3745
Dr. Darwin Dalen, O.D.
Optometrist
Medicare: Accepting Medicare Assignments
Practice Location: 201 Nw 4th St, Grand Rapids, MN 55744
Phone: 218-326-9619    Fax: 218-326-9619
Corey H Tabbert Od Pa
Optometrist
Medicare: Medicare Enrolled
Practice Location: 15 Ne 5th St, Grand Rapids, MN 55744
Phone: 218-327-1148    
Vision Pro Ii, Inc
Optometrist
Medicare: Not Enrolled in Medicare
Practice Location: 3150 S Pokegama Ave Ste 103, Grand Rapids, MN 55744
Phone: 218-327-0070    Fax: 218-327-0070
Eye Fashions Optical Shoppe Inc
Optometrist
Medicare: Medicare Enrolled
Practice Location: 202 Nw 1st Ave, Grand Rapids, MN 55744
Phone: 218-326-0358    Fax: 218-326-0358

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.