Dr Leroy Taylor Kincannon Iii, OD in Grand Rapids, MN

Dr Leroy Taylor Kincannon Iii, OD is a medicare enrolled "Optometrist" provider in Grand Rapids, Minnesota. His current practice location is 1542 Golf Course Rd, Suite 201, Grand Rapids, Minnesota. You can reach out to his office (for appointments etc.) via phone at (218) 326-3433.

Dr Leroy Taylor Kincannon Iii is licensed to practice in Minnesota (license number 2466) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1528173846.

Contact Information

	Dr Leroy Taylor Kincannon Iii, OD
	1542 Golf Course Rd, Suite 201, Grand Rapids, MN 55744-9603
	(218) 326-3433
	(218) 326-3435

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Leroy Taylor Kincannon Iii
Gender	Male
Speciality	Optometrist
Location	1542 Golf Course Rd, Grand Rapids, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1528173846
Provider Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 1951364298
Enrollment ID: I20041108001208

Medical Identifiers

Medical identifiers for Dr Leroy Taylor Kincannon Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1528173846	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	2466 (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 Leroy Taylor Kincannon Iii allows following entities to bill medicare on his behalf.

Provider Name	John L Bonner Eye Clinic Ltd
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1053351817 PECOS PAC ID: 0547243677 Enrollment ID: O20040610000493

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 Leroy Taylor Kincannon Iii 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
Dr Leroy Taylor Kincannon Iii, OD 3221 E 4th St, Duluth, MN 55804-1831 Ph: (218) 260-8536	Dr Leroy Taylor Kincannon Iii, OD 1542 Golf Course Rd, Suite 201, Grand Rapids, MN 55744-9603 Ph: (218) 326-3433

Reviews and Comments

Optometrist in Grand Rapids, MN

John L Bonner Eye Clinic Ltd Optometrist Medicare: Medicare Enrolled Practice Location: 1542 Golf Course Rd, Suite 201, Grand Rapids, MN 55744 Phone: 218-326-3433 Fax: 218-326-3435
Heidi Dahlberg, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 100 Se 29th St, Grand Rapids, MN 55744 Phone: 218-326-1101 Fax: 218-326-1106
Paul Lee Dubbels, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 710 S Pokegama Ave, Grand Rapids, MN 55744 Phone: 218-326-1775 Fax: 218-326-3745
Dr. Darwin Dalen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 201 Nw 4th St, Grand Rapids, MN 55744 Phone: 218-326-9619 Fax: 218-326-9619
Corey H Tabbert Od Pa Optometrist Medicare: Medicare Enrolled Practice Location: 15 Ne 5th St, Grand Rapids, MN 55744 Phone: 218-327-1148
Vision Pro Ii, Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3150 S Pokegama Ave Ste 103, Grand Rapids, MN 55744 Phone: 218-327-0070 Fax: 218-327-0070
Eye Fashions Optical Shoppe Inc Optometrist Medicare: Medicare Enrolled Practice Location: 202 Nw 1st Ave, Grand Rapids, MN 55744 Phone: 218-326-0358 Fax: 218-326-0358

Dr Leroy Taylor Kincannon Iii, OD - Medicare Optometrist in Grand Rapids, MN