Dr Mark T Mcdermott, OD | |
2353 Rice St, Ste 206, Roseville, MN 55113 | |
(651) 483-8148 | |
(651) 483-3206 |
Full Name | Dr Mark T Mcdermott |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 2353 Rice St, Roseville, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083680599 | NPI | - | NPPES |
22 07646 | Other | MN | MEDICA |
26613 | Other | MN | HEALTH PARTNERS |
152713400 | Medicaid | MN | |
615152747 | Other | MN | METROPOLITAN HEALTH PLAN |
124899 | Other | MN | U CARE |
57D32MC | Other | MN | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2594 (Minnesota) | Primary |
152W00000X | Optometrist | 02169 (Iowa) | Secondary |
Provider Name | Southside Community Health Services Inc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1538137757 PECOS PAC ID: 8921027228 Enrollment ID: O20051116000311 |
Mailing Address | Practice Location Address |
---|---|
Dr Mark T Mcdermott, OD 2353 Rice St, Ste. 206, Roseville, MN 55113-3739 Ph: (651) 483-8148 | Dr Mark T Mcdermott, OD 2353 Rice St, Ste 206, Roseville, MN 55113 Ph: (651) 483-8148 |
Dr. Robert Bach Kennedy, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1790 Lexington Ave N, Roseville, MN 55113 Phone: 651-488-6771 Fax: 651-488-5576 | |
Courtland J Watson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2480 Fairview Ave N, Rosedale Commons, Roseville, MN 55113 Phone: 651-639-0407 Fax: 651-639-2503 | |
Dr. Thomas Joseph Meyer, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 406 Rosedale Shopping Ctr, Pearle Vision, Roseville, MN 55113 Phone: 651-631-9394 Fax: 651-631-9698 | |
Drs. North & Watson, Optometrists P. A. Optometrist Medicare: Medicare Enrolled Practice Location: 2480 Fairview Ave N, Roseville, MN 55113 Phone: 651-639-0407 Fax: 651-639-2503 | |
Optometric Services, Llc Optometrist Medicare: Medicare Enrolled Practice Location: 406 Rosedale Center, Pearle Vision Express, Roseville, MN 55113 Phone: 651-631-9394 | |
Trevor Mox, OD Optometrist Medicare: Medicare Enrolled Practice Location: 503 Rosedale Shopping Ctr, Roseville, MN 55113 Phone: 651-631-8900 Fax: 651-631-1003 |