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

Grant Robert Carlisle

Individual provider Ophthalmology Physician · NPI 1063075224

Grant Robert Carlisle is an Ophthalmology in Grand Rapids, Minnesota. Graduated from University of Minnesota Medical School in 2019, 7 years ago. Practices with John L Bonner Eye Clinic Ltd, a 4-clinician group and accepts Medicare assignment. Licensed in Minnesota and Pennsylvania.

Years since qualifying
7
Trained at
University of Minnesota Medical School
Licensed in
MN, PA
In the registry since
2019
Specialties on file
2

Practice location Address checks out

1542 Golf Course Rd Ste 201
Grand Rapids, MN 55744-3537
Phone: (218) 326-3433
Fax: (218) 326-3435
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence 76307 (MN)
Ophthalmology Physician Taxonomy 207W00000X · Licence MD481576 (PA)

Record details

NPI number1063075224
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 15, 2019
Last updated in NPPESJanuary 16, 2025
Certification dateJanuary 16, 2025

Medicare enrollment

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

Medicare specialtyOPHTHALMOLOGY
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 2019 (7 years in practice)
Group practice John L Bonner Eye Clinic Ltd — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Grand Rapids