Individual provider Active NPI

Gregory Michael Falk, O.D.

  • Optometrist
  • Woodbury, MN
National Provider Identifier
1124139886
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2856 Issued in MN
Practice address
10240 Hudson Rd
Wal-Mart Vision Center
Woodbury, MN 55129-9111
Phone
(651) 735-5196
Fax
(651) 735-5198
NPI assigned
Aug 31, 2006
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2856 MN Primary

Addresses

Primary practice location

10240 Hudson Rd
Wal-Mart Vision Center
Woodbury, MN 55129-9111

Mailing address

1593 Headwaters LN
Woodbury, MN 55129-6233
Phone (651) 337-0374

Other practice location 1

5815 Norell Ave N
Oak Park Heights, MN 55082-1766
Phone (651) 351-3976

Other practice location 2

1850 Buerkle Rd
White Bear Lake, MN 55110-5245
Phone (651) 779-9346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041101000980 MN Practitioner - Optometry 0345202479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Falk Optometric Group, IncGroup PAC ID 0941239255, 2 clinicians

Practice addresses (Care Compare)

10240 Hudson Rd
Woodbury, MN 55129-9111
Phone (651) 735-5196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Falk Optometric Group, Inc Optometrist CurrentSince Sep 9, 2010 Accepting new patients
Falk Optometric Group, Inc. Optometrist Past Accepting new patients

Locations

5815 Norell Ave N
Stillwater, MN 55082
Phone (651) 351-3976

1850 Buerkle Rd
White Bear Lake, MN 55110
Phone (651) 779-6710

10240 Hudson Rd
Woodbury, MN 55129
Phone (651) 735-5190

9925 Hudson Pl
Woodbury, MN 55125
Phone (651) 702-1231

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1124139886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 HEADWATERS LN",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551296233",
            "telephone_number": "651-337-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10240 HUDSON RD",
            "address_2": "WAL-MART VISION CENTER",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551299111",
            "telephone_number": "651-735-5196",
            "fax_number": "651-735-5198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5815 Norell Ave N",
            "address_purpose": "LOCATION",
            "city": "Oak Park Heights",
            "state": "MN",
            "postal_code": "550821766",
            "country_code": "US",
            "telephone_number": "651-351-3976",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1850 Buerkle Rd",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "551105245",
            "country_code": "US",
            "telephone_number": "651-779-9346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FALK",
        "first_name": "GREGORY",
        "middle_name": "MICHAEL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.