AVERA MEDICAL GROUP OPTOMETRY WORTHINGTON
NPI 1174077275
Optometrist in Worthington, MN
About Avera Medical Group Optometry Worthington NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AVERA MEDICAL GROUP OPTOMETRY WORTHINGTON (NPI 1174077275) is a healthcare organization registered as an optometrist in Worthington, Minnesota and active in the NPI registry since August 2016. The organization lists David Flicek, Ceo/president, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Avera Medical Group Optometry Worthington is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
75Medicare enrollment records show 75 clinicians reassign Medicare billing to Avera Medical Group Optometry Worthington, which bills Medicare for the services they deliver. Of these, 17 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 12
Nearest to this location (20)
See all 75Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Avera Mckennan's NPI number?
The NPI number for Avera Mckennan is 1174077275. It was assigned to this organization in the NPPES registry on August 8, 2016. The provider is doing business as Avera Medical Group Optometry Worthington.
Where is Avera Mckennan located?
Avera Mckennan is located at 702 10th St, Worthington, MN 56187. The listed phone number is (507) 376-5535.
What is Avera Mckennan's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Avera Mckennan enrolled in Medicare?
Yes. Avera Mckennan is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Avera Mckennan?
According to the CMS Revalidation Reassignment List (October 2026 release), 75 clinicians in 12 Medicare specialties reassign their Medicare billing to Avera Mckennan. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (16), Family Practice (14) and Nurse Practitioner (9). Of these, 17 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Avera Mckennan was last updated on October 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.
# Avera Medical Group Optometry Worthington · NPI 1174077275
Optometrist organization in Worthington, Minnesota. Organization record, active in the CMS NPPES registry since August 8, 2016.
## Identity
- **NPI:** 1174077275 (Entity type: Organization)
- **Enumerated:** August 8, 2016
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Legal business name:** Avera Mckennan
- **Organization subpart:** No
- **Authorized official:** David Flicek, CEO/PRESIDENT
## Practice location
- **Address:** 702 10TH ST, Worthington, MN 56187-2767
- **Phone:** (507) 376-5535
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 75 clinicians in 12 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (16), Family Practice (14), Nurse Practitioner (9); 17 practice within 10 miles; [full list](https://npiprofile.com/npi/1174077275/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 24, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1174077275) · Data from the CMS NPPES public registry.