Jacob Peder Bollman, OD is a medicare enrolled "Optometrist" provider in Clarkfield, Minnesota. He went to Pacific University - College Of Optometry and graduated in 2013 and has 11 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Granite Falls Eyecare Inc and his current practice location is
4559 290th Ave, Clarkfield, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(701) 388-9476.
Jacob Peder Bollman is licensed to practice in Minnesota (license number 3352) 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 1811336043.
Healthcare Provider's Profile
| Full Name | Jacob Peder Bollman |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 11 Years |
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| Location | 4559 290th Ave, Clarkfield, 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:
- Jacob Peder Bollman attended and graduated from Pacific University - College Of Optometry in 2013
NPI Data:
- NPI Number: 1811336043
- Provider Enumeration Date: 06/20/2013
- Last Update Date: 06/20/2013
Medicare PECOS Information:
- PECOS PAC ID: 3274767454
- Enrollment ID: I20131001000083
Medical Identifiers
Medical identifiers for Jacob Peder Bollman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1811336043 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 3352 (Minnesota) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Granite Falls Eyecare Inc | 2163493081 | 2 |
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. Jacob Peder Bollman allows following entities to bill medicare on his behalf.
| Provider Name | Midwest Vision Centers Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1346343423
PECOS PAC ID: 7517864234
Enrollment ID: O20031218000868 |
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| Provider Name | Granite Falls Eyecare Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1851445464
PECOS PAC ID: 2163493081
Enrollment ID: O20040804000737 |
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| Provider Name | Shoptikal Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1942866371
PECOS PAC ID: 1456684471
Enrollment ID: O20190611002309 |
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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. Jacob Peder Bollman 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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Jacob Peder Bollman, OD
4559 290th Ave,
Clarkfield, MN 56223-3570
Ph: (701) 388-9476 | Jacob Peder Bollman, OD
4559 290th Ave,
Clarkfield, MN 56223-3570
Ph: (701) 388-9476 |
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