Dr Michael S Petronack, OD is a medicare enrolled "Optometrist" provider in Hugo, Minnesota. He went to Illinois College Of Optometry At Chicago and graduated in 1994 and has 30 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Eagan Eye Clinic Llc and his current practice location is
5679 147th St N, Hugo, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(651) 762-9545.
Dr Michael S Petronack is licensed to practice in Minnesota (license number 2544) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1295891596.
Healthcare Provider's Profile
| Full Name | Dr Michael S Petronack |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 30 Years |
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| Location | 5679 147th St N, Hugo, Minnesota |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Michael S Petronack attended and graduated from Illinois College Of Optometry At Chicago in 1994
NPI Data:
- NPI Number: 1295891596
- Provider Enumeration Date: 12/29/2006
- Last Update Date: 06/27/2013
Medicare PECOS Information:
- PECOS PAC ID: 8022257633
- Enrollment ID: I20130611000758
Medical Identifiers
Medical identifiers for Dr Michael S Petronack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1295891596 | NPI | - | NPPES |
| 3868206-00 | Medicaid | MN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 2544 (Minnesota) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Eagan Eye Clinic Llc | 0345220745 | 36 |
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 Michael S Petronack allows following entities to bill medicare on his behalf.
| Provider Name | Eagan Eye Clinic Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1477732337
PECOS PAC ID: 0345220745
Enrollment ID: O20040726000300 |
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| Provider Name | Dr. Petronack & Associates, Optometrists, Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1578778296
PECOS PAC ID: 6406095017
Enrollment ID: O20130611000737 |
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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. Dr Michael S Petronack 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 |
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Dr Michael S Petronack, OD
5679 147th St N,
Hugo, MN 55038-9302
Ph: (651) 762-9545 | Dr Michael S Petronack, OD
5679 147th St N,
Hugo, MN 55038-9302
Ph: (651) 762-9545 |
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