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DR. MARK T MCDERMOTT OD
NPI 1083680599
Optometrist in Minneapolis, MN

Active since February 24, 2006PECOS EnrolledAccepts Medicare Assignment
4243 4TH AVE S, MINNEAPOLIS, MN 55409(612) 821-2003(612) 821-2818 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Mark T Mcdermott Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK T MCDERMOTT OD (NPI 1083680599) is an individual optometrist in Minneapolis, Minnesota, licensed in Minnesota (2594) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (1996).

NPPES Registry Identity

NPI1083680599
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. MARK T MCDERMOTTCredential: OD
Location Address4243 4TH AVE SMinneapolis, MN 55409-2113
Mailing Address4243 4th Ave SMinneapolis, MN 55409-2113 · (612) 821-2003 · Fax (612) 821-2818
Phone(612) 821-2003
Fax(612) 821-2818
Sole ProprietorNo
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 1996
Enumeration DateFebruary 24, 2006
Last NPPES UpdateJune 16, 2025
NPPES CertifiedJune 16, 2025
✔ NPI 1083680599 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in MN · 2594✔ Licensed in IA · 02169
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
4243 4TH AVE S, Minneapolis, MN 55409
Open in Google Maps ↗

Other Identifiers 6

Other22 07646MN · Medica
Other124899MN · U Care
Other615152747MN · Metropolitan Health Plan
Medicaid152713400MN
Other26613MN · Health Partners
Other57D32MCMN · Blue Cross Blue Shield

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mark T Mcdermott Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739284779
PECOS Enrollment IDI20070419000235
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55409 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHERYL ROMANA DDS
Dentist
4243 4TH AVE S
MINNEAPOLIS, MN 55409
Hennepin County (612) 822-9030
DR. MARY LOUISE TRUCHON CRACKEL D.D.S.
Dentist (General Practice)
4243 4TH AVE S
MINNEAPOLIS, MN 55409
Hennepin County (612) 822-9030
GAURANG BHARATKUMAR BHATT DDS
Dentist (General Practice)
4243 4TH AVE S
MINNEAPOLIS, MN 55409
Hennepin County (612) 822-9030
VIA MARITH NESS RDH
Dental Hygienist
4243 4TH AVE S
MINNEAPOLIS, MN 55409
Hennepin County (612) 822-9030
DR. NICOLETA TEREZIA AGRIGOROAE BOLOS DDS
Dentist
4243 4TH AVE S
MINNEAPOLIS, MN 55409
Hennepin County (612) 822-9030
DR. MARIA KATALINA ZUNIGA-BRENES DDS
Dentist (General Practice)
4243 4TH AVE S
MINNEAPOLIS, MN 55409
Hennepin County (612) 822-9030
JONEE ELIZABETH MEAGHER O.D.
Optometrist
4243 4TH AVE S
MINNEAPOLIS, MN 55409
Hennepin County (612) 821-2003
LONG THAO D.D.S.
Dentist
4243 4TH AVE S
MINNEAPOLIS, MN 55409
Hennepin County (612) 822-9030

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Mcdermott's NPI number?

The NPI number for Mark Mcdermott is 1083680599. It was assigned to this individual provider in the NPPES registry on February 24, 2006.

Where is Mark Mcdermott located?

Mark Mcdermott practices at 4243 4th Ave S, Minneapolis, MN 55409. The listed phone number is (612) 821-2003.

What is Mark Mcdermott's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Mark Mcdermott enrolled in Medicare?

Yes. Mark Mcdermott is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Mark Mcdermott was last updated on June 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.