Dr Heather Marie Bergerud, OD is a medicare enrolled "Optometrist" provider in St. Louis Park, Minnesota. Her current practice location is
3745 Louisiana Ave S, St. Louis Park, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(952) 922-4427.
Dr Heather Marie Bergerud is licensed to practice in Minnesota (license number 2621) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1669545018.
Healthcare Provider's Profile
| Full Name | Dr Heather Marie Bergerud |
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| Gender | Female |
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| Speciality | Optometrist |
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| Location | 3745 Louisiana Ave S, St. Louis Park, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1669545018
- Provider Enumeration Date: 11/15/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 2961595285
- Enrollment ID: I20070914000431
Medical Identifiers
Medical identifiers for Dr Heather Marie Bergerud such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669545018 | NPI | - | NPPES |
| 2201839 | Other | MN | MEDICA |
| 300J5BE | Other | MN | BCBS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 2621 (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 Heather Marie Bergerud allows following entities to bill medicare on her behalf.
| Provider Name | Luxottica Of America Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1487706271
PECOS PAC ID: 2567366180
Enrollment ID: O20040405000629 |
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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 Heather Marie Bergerud 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 Heather Marie Bergerud, OD
290 Greenleaf Ct.,
Chanhassen, MN 55317
Ph: (952) 403-1694 | Dr Heather Marie Bergerud, OD
3745 Louisiana Ave S,
St. Louis Park, MN 55426
Ph: (952) 922-4427 |
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