Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Mark T McDermott, OD

Individual provider Optometrist · NPI 1083680599

Dr. Mark T McDermott, OD is an Optometry in Minneapolis, Minnesota. Graduated from Illinois College of Optometry at Chicago in 1996, 30 years ago. Practices with Southside Community Health Services Inc, a 17-clinician group and accepts Medicare assignment. Licensed in Iowa and Minnesota.

Years since qualifying
30
Trained at
Illinois College of Optometry at Chicago
Licensed in
IA, MN
In the registry since
2006
Specialties on file
2
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

4243 4th Ave S
Minneapolis, MN 55409-2113
Phone: (612) 821-2003
Fax: (612) 821-2818
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 2594 (MN)
Optometrist Taxonomy 152W00000X · Licence 02169 (IA)

Record details

NPI number1083680599
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedFebruary 24, 2006
Last updated in NPPESJune 16, 2025
Certification dateJune 16, 2025
Mailing address4243 4th Ave S, Minneapolis, MN 55409-2113

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated 1996 (30 years in practice)
Group practice Southside Community Health Services Inc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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