MEDICARE: SCOTT A FRICK OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2685	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	410049439	OTHER	MN	MEDICARE RAILROAD
10	410001615	OTHER	MN	MEDICARE
12	410045202	OTHER	MN	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HP30592	OTHER	MN	HEALTH PARTNERS
2	165185	OTHER	MN	COLE MANAGED VISION
3	22-01181	OTHER	MN	MEDICA PRIMARY
4	22-08371	OTHER	MN	SELECT CARE
5	935301023286	OTHER	MN	PREFERRED ONE
6	22-01177	OTHER	MN	MEDICA CHOICE
7	36B91FR	OTHER	MN	BLUE CROSS/BLUE SHIELD
9	9641110232861	OTHER	MN	PREFERRED ONE
11	22-08371	OTHER	MN	MEDICA CHOICE
13	22-01177	OTHER	MN	SELECT CARE
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	150163	OTHER	MN	UCARE SRS AND MN
16	644S8FR	OTHER	MN	BLUE CROSS/BLUE SHIELD
17	862671	OTHER	MN	ARAZ/AMERICA'S PPO

General Provider Information

NPI Number	:	1043214091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT A FRICK OD

Provider Business Mailing Address
First Line	:	13645 GROVE DR
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-4405
Country	:	US
Telephone Number	:	763-420-8030
Fax Number	:	763-420-9842

Provider Business Practice Location Address
First Line	:	13645 GROVE DR N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-4405
Country	:	US
Telephone Number	:	763-420-8030
Fax Number	:	763-420-9842

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	02/18/2020

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Directions to “ SCOTT A FRICK OD” Practice Location

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