Gregory Clark, O.d., Inc. - Medicare Optometrist in Coon Rapids, MN

Gregory Clark, O.d., Inc. is a medicare enrolled "Optometrist" provider in Coon Rapids, Minnesota. Their current practice location is 12547 Riverdale Blvd Nw, Costco Optical Department, Coon Rapids, Minnesota. You can reach out to their office (for appointments etc.) via phone at (763) 712-7761.

Gregory Clark, O.d., Inc. is licensed to practice in Minnesota (license number 2806) and it also participates in the medicare program. Gregory Clark, O.d., Inc. 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 1801965504.

Contact Information

Gregory Clark, O.d., Inc.
12547 Riverdale Blvd Nw, Costco Optical Department,
Coon Rapids, MN 55448-6708
(763) 712-7761
(763) 712-7787

Map and Direction




Healthcare Provider's Profile

Full NameGregory Clark, O.d., Inc.
TypeFacility
SpecialityOptometrist
Location12547 Riverdale Blvd Nw, Coon Rapids, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1801965504
  • Provider Enumeration Date: 11/07/2006
  • Last Update Date: 11/29/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 5799880142
  • Enrollment ID: O20070413000415

Medical Identifiers

Medical identifiers for Gregory Clark, O.d., Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1801965504NPI-NPPES
1634747-00MedicaidMN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 2806 (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. Gregory Clark, O.d., Inc. acts as a billing entity for following providers:
Provider NameJason J Stensos
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1205844966
PECOS PAC ID: 8325078322
Enrollment ID: I20050819000023
Provider NameGregory A Clark
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1467521153
PECOS PAC ID: 8426153867
Enrollment ID: I20070413000410

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. Gregory Clark, O.d., Inc. 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
Gregory Clark, O.d., Inc.
16160 22nd Pl N,
Plymouth, MN 55447-2382

Ph: (612) 703-0298
Gregory Clark, O.d., Inc.
12547 Riverdale Blvd Nw, Costco Optical Department,
Coon Rapids, MN 55448-6708

Ph: (763) 712-7761

Reviews and Comments


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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.