Great River Eye Clinic – Health Service Clinic/Center, NPI 1023424926

Great River Eye Clinic is a healthcare provider. based in Crosby, Minnesota. specializing in Health Service Clinic/Center. The NPI Number for Great River Eye Clinic is 1023424926

Main info

Organization
Name
Great River Eye Clinic
NPI
1023424926
Phone
(218) 546-5108
Address
1 3RD AVE NE
Authorized Official
DR. STACY ANN SJOBERG OWNER M.D., PH.D
Enumeration Date
11 July 2014
Last Update Date
23 August 2021
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness80
Years active:11State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Great River Eye Clinic

  • 1 3RD AVE NE

    CROSBY, MN 564411665

    Phone: (218) 546-5108

    Fax: (218) 546-5736

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-02-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-08-31 (284 days ago).

Enrollment records

2

Earliest due date

2025-08-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20140912001243OClinic/Group PracticeMN2025-09-30
O20150204001488OPhysician - OptometristMN2025-08-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56441)

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Reviews

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Frequently asked questions

What is the standard ID for Great River Eye Clinic in the U.S.?
In the U.S., Great River Eye Clinic is identified by NPI 1023424926.
Should I treat Great River Eye Clinic as an active provider?
Patients and plans typically see Great River Eye Clinic as active in the national extract.
Which specialty label fits Great River Eye Clinic?
NPPES ties Great River Eye Clinic to Health Service Clinic/Center in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Great River Eye Clinic?
The directory associates Great River Eye Clinic with Crosby, Minnesota. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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