Gregory M Macik, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

MN2973 Issued in MN

Practice address

101 Willmar Ave SW
Affiliated Community Medical Centers
Willmar, MN 56201

Phone

(320) 231-5000

Fax

(220) 231-5067

NPI assigned

Jun 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Electronic endpoints 1

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

Specialty

Optometry

Education

Southern College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmacik440135@direct.centracare.com

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

• Centracare Clinic Southwest LLC

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1174106264
  Medicare reassignment Care Compare group NPD
• Dr. Gregory M. Macik, Optometrist, P.a.

  • Optometrist
  • Burnsville, MN
  • NPI 1730100181
  NPD (past) Authorized official
• Metropolitan Eye Care Specialists

  • Ophthalmology Physician
  • Burnsville, MN
  • NPI 1447404645
  NPD (past) Authorized official
• Centracare Clinic Southwest LLC

  • Durable Medical Equipment & Medical Supplies
  • Willmar, MN
  • NPI 1912664889

  Optometrist

  NPD
• Cornerstone Vision Clinic LLC

  • Eyewear Supplier
  • Saint Michael, MN
  • NPI 1932266111
  NPD (past)
• Crossroads Optometric Clinic, Inc.

  • Optometrist
  • Prior Lake, MN
  • NPI 1164448627
  NPD (past)
• Southwest Eye Care Inc

  • Ophthalmology Physician
  • Chaska, MN
  • NPI 1679623862

  Optometrist

  NPD (past)
• Vision World Inc

  • Eyewear Supplier
  • Fergus Falls, MN
  • NPI 1982789533
  NPD (past)
• Visionworks Inc

  • Eyewear Supplier
  • Omaha, NE
  • NPI 1205924792
  NPD (past)

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1922004514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-231-5000",
            "fax_number": "220-231-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-231-5000",
            "fax_number": "220-231-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIK",
        "first_name": "GREGORY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "MN2973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "339M8MA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA/UNITED HEALTH CARE",
            "identifier": "22-02526",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "2237465",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE MANAGED VISION CARE",
            "identifier": "222010",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650127300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION CARE",
            "identifier": "MN2973",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmacik440135@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "gmacik440135@direct.centracare.com",
            "address_1": "101 Willmar Ave SW",
            "address_2": "Affiliated Community Medical Centers",
            "city": "Willmar",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kendra Lund, DPT
• Larissa Nichole Lurken, NP
• Lutheran Social Service of Minnesota
• Ashraf Hussein Maalin
• Melissa Ann Maas, PSYD LP
• Taylor Madsen
• Kerriann Mahon, MD
• Alexandra Malkuch, CRNA
• James Malkuch, CRNA
• Ross Edwin Malkuch, CRNA

• Optometrist in Willmar, MN
• Providers in Willmar, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.