Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1467521153 Individual Practitioner Male Practitioner

Dr. Gregory Alexander Clark , OD

Optometrist • Coon Rapids, MN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Gregory Clark, OD is a certified Optometrist practicing in Coon Rapids, MN. With approximately 25 years of clinical experience since graduating from Illinois College Of Optometry At Chicago in 2001, Dr. Clark delivers high-quality medical care to the local community at 12547 RIVERDALE BLVD NW.

Dr. Clark is affiliated with Gregory Clark, O.D., Inc. and accepts Medicare assignment.

Frequently performed procedures and clinical services include new patient complete exam of visual system, established patient complete exam of visual system. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

12547 Riverdale Blvd Nw
Costco Optical Department

Coon Rapids, MN 554486708

Telephone 7637127761
Fax 7637127787
Associated Practice Facility / Clinic
🏢 Costco Wholesale Corporation Facility NPI 1568572188

Medicare Profile & Education

Medical School

Illinois College Of Optometry At Chicago

Graduation Year

2001

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Coon Rapids, MN

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
25 Yrs +5.1 yrs vs City Avg
City Avg: 19.9 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
19 Specialists

Practicing in Coon Rapids, MN (1178 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
1.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Clark (25 Years) 25 Yrs
Coon Rapids Specialty Average (19.9 Years) 19.9 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92004 New patient complete exam of visual system
74 74 $139.00 $137.24
92014 Established patient complete exam of visual system
73 72 $119.00 $117.71

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License MN 2806

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
163474700 (MN)

Hospital & Practice Group Affiliations

Gregory Clark, O.d., Inc.

12547 Riverdale Blvd Nw, Coon Rapids, MN 554486708

Phone: 7637127761

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1770866865

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 29, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location November 29, 2012

Registered at 12547 RIVERDALE BLVD NW, COSTCO OPTICAL DEPARTMENT, COON RAPIDS, MN 554486708 (Tel: 7637127761)

📍
Updated Business Mailing Address November 29, 2012

Registered at 16160 22ND PL N, PLYMOUTH, MN 554472382 (Tel: 6127030298)

👤
Provider Name / Credentials Updated November 29, 2012

Recorded as GREGORY CLARK, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 29, 2012

Optometrist (License #2806 in MN)

🟢
Initial NPI Registration & Enumeration November 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1467521153
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 07, 2006
Last Update: November 29, 2012
Sole Proprietor: No

Mailing Address

16160 22nd Pl N

Plymouth, MN 554472382

Phone: 6127030298

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.