Germaine E Cheslock, O.D.
Individual provider Active NPI Optometrist · Bemidji, MN
NPI 1154468890 · NPPES record last updated Feb 1, 2023
Key facts
- NPI
- 1154468890
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2300 (MN)
- Practice address
- 1611 Anne St NW
Bemidji, MN 56601-5114 - Phone
- (218) 333-2020
- Fax
- (218) 333-2019
- NPI assigned
- Jan 31, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 23
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Health of Northern Minnesota
Practice addresses (Care Compare)
1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000
1656 Central St W
Bagley, MN 56621-4357
Phone (218) 694-2384
PO Box
Suite 5074
Sioux Falls, SD 57117-5074
Hospital & facility affiliations
- Sanford Bemidji Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.56 of 100
- Quality
- 74.25
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.16
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 34 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070723000840 | MN | Practitioner - Optometry | 9335240191 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2300 | MN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Health of Northern Minnesota | Current |
Accepting new patients | |
| Sanford Health of Northern Minnesota | Optometrist | Current | Accepting new patients |
| Sanford Health of Northern Minnesota | Current |
Accepting new patients | |
| Sanford Medical Center Fargo | Past | Accepting new patients |
Locations
1656 Central St W
Ste A
Bagley, MN 56621
Phone (218) 694-2442
1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020
1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481
4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 2300 | MN | |
| Optometrist | 152W00000X | 2300 | MN | Yes |
Addresses
Primary practice location
1611 Anne St NW
Bemidji, MN 56601-5114
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 942G7CH | Other | MN | MN BCBS |
| 1011212 | Other | PREFERREDONE | |
| 571725600 | Medicaid | MN | |
| 2204340 | Other | MEDICA | |
| 28642 | Other | ND | ND BCBS |
| HP57666 | Other | HEALTHPARTNERS |
Other providers in Bemidji, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.