Blaine Eye Clinic - Medicare in Blaine, MN

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Blaine Eye Clinic is a medicare enrolled "Durable Medical Equipment & Medical Supplies" provider in Blaine, Minnesota. Their current practice location is 12170 Aberdeen St Ne, Blaine, Minnesota. You can reach out to their office (for appointments etc.) via phone at (763) 757-7000.

Blaine Eye Clinic is licensed to practice in Minnesota (license number ) and it also participates in the medicare program. Blaine Eye Clinic 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 1043363401.

Contact Information

Blaine Eye Clinic
12170 Aberdeen St Ne,
Blaine, MN 55449-4716
(763) 757-7000
(763) 757-3328

Map and Direction




Healthcare Provider's Profile

Full NameBlaine Eye Clinic
TypeFacility
SpecialityDurable Medical Equipment & Medical Supplies
Location12170 Aberdeen St Ne, Blaine, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1043363401
  • Provider Enumeration Date: 01/19/2007
  • Last Update Date: 02/15/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 2264479575
  • Enrollment ID: O20050408000253

Medical Identifiers

Medical identifiers for Blaine Eye Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043363401NPI-NPPES
DB3402OtherMNRAILROAD MEDICARE
221526800MedicaidMN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist (Minnesota)Secondary
332B00000XDurable Medical Equipment & Medical Supplies (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. Blaine Eye Clinic acts as a billing entity for following providers:
Provider NameRosamond H Tedesco
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1548469737
PECOS PAC ID: 8820169949
Enrollment ID: I20080618000082
Provider NameBreann M Forliti
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1265694715
PECOS PAC ID: 8022186485
Enrollment ID: I20081013000138
Provider NameGeorgiann K Jensen
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1134272586
PECOS PAC ID: 9335186659
Enrollment ID: I20110210000585
Provider NameLynn A Sulerud
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1013060409
PECOS PAC ID: 2062459381
Enrollment ID: I20110210000620
Provider NameMegan M Sis
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1013242197
PECOS PAC ID: 4183872054
Enrollment ID: I20140428000547
Provider NameCasey W Bateman
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1720439466
PECOS PAC ID: 7113213265
Enrollment ID: I20160915001839
Provider NameAshley A Berens
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1417462698
PECOS PAC ID: 4486905247
Enrollment ID: I20180918004162
Provider NameEmmalee A Toldo
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1770069494
PECOS PAC ID: 1355694233
Enrollment ID: I20181023000309
Provider NameLandon Michael Kudrna
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1285206318
PECOS PAC ID: 5092110544
Enrollment ID: I20210820001439

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. Blaine Eye Clinic 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
Blaine Eye Clinic
12170 Aberdeen St Ne,
Blaine, MN 55449-4716

Ph: (763) 757-7000		Blaine Eye Clinic
12170 Aberdeen St Ne,
Blaine, MN 55449-4716

Ph: (763) 757-7000

Reviews and Comments



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.