Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1083680599 Individual Practitioner Male Practitioner

Dr. Mark T Mcdermott , OD

Optometrist • Minneapolis, MN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Mark Mcdermott, OD is a certified Optometrist practicing in Minneapolis, MN. With approximately 30 years of clinical experience since graduating from Illinois College Of Optometry At Chicago in 1996, Dr. Mcdermott delivers high-quality medical care to the local community at 4243 4TH AVE S.

Dr. Mcdermott is affiliated with Southside Community Health Services Inc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

4243 4th Ave S

Minneapolis, MN 554092113

Telephone 6128212003
Fax 6128212818
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Illinois College Of Optometry At Chicago

Graduation Year

1996

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Minneapolis, MN

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
30 Yrs +11.7 yrs vs City Avg
City Avg: 18.3 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
68 Specialists

Practicing in Minneapolis, MN (1178 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mcdermott (30 Years) 30 Yrs
Minneapolis Specialty Average (18.3 Years) 18.3 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-06-16
Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License MN 2594

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.

Optometrist

NUCC Taxonomy Code: 152W00000X

State License IA 02169

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
152713400 (MN)
Commercial Insurance / Payer ID Medica
22 07646 (MN)
Commercial Insurance / Payer ID U Care
124899 (MN)
Commercial Insurance / Payer ID Metropolitan Health Plan
615152747 (MN)
Commercial Insurance / Payer ID Health Partners
26613 (MN)
Commercial Insurance / Payer ID Blue Cross Blue Shield
57D32MC (MN)

Hospital & Practice Group Affiliations

Southside Community Health Services Inc

4243 4th Ave S, Minneapolis, MN 554092113

Southside Community Health Services Inc

4243 4th Ave S, Minneapolis, MN 554092113

Practice Associates & Co-Workers

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

9 Associated Practitioners
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Dr. Maria Zuniga-Brenes , DDS

Dentist - General Practice

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NPI 1447538608

Doctor of Optometry

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Practice Location June 16, 2025

Registered at 4243 4TH AVE S, MINNEAPOLIS, MN 554092113 (Tel: 6128212003)

📍
Updated Business Mailing Address June 16, 2025

Registered at 4243 4TH AVE S, MINNEAPOLIS, MN 554092113 (Tel: 6128212003)

NPI Profile Active May 09, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location May 09, 2008

Registered at 2353 RICE ST, STE 206, ROSEVILLE, MN 55113 (Tel: 6514838148)

📍
Updated Business Mailing Address May 09, 2008

Registered at 2353 RICE ST, STE. 206, ROSEVILLE, MN 551133739 (Tel: 6514838148)

👤
Provider Name / Credentials Updated May 09, 2008

Recorded as MARK MCDERMOTT, OD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 09, 2008

Optometrist (License #2594 in MN)

🟢
Initial NPI Registration & Enumeration February 24, 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: 1083680599
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 24, 2006
Last Update: June 16, 2025
Sole Proprietor: No

Mailing Address

4243 4th Ave S

Minneapolis, MN 554092113

Phone: 6128212003

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.