NPIMap

Individual provider Active NPI

Laura Lou Lhotka, MD

  • Family Medicine Physician
  • Detroit Lakes, MN
National Provider Identifier
1003470048
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
67908 Issued in MN
Practice address
1027 Washington Ave
Detroit Lakes, MN 56501-3409
Phone
(218) 844-2300
NPI assigned
Apr 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 67908 MN Primary

Addresses

Primary practice location

1027 Washington Ave
Detroit Lakes, MN 56501-3409

Mailing address

1027 Washington Ave
Detroit Lakes, MN 56501-3409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221107000130 MN Practitioner - Family Practice 4880028737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Regional Health CenterGroup PAC ID 2062326820, 190 clinicians

Practice addresses (Care Compare)

1027 Washington Ave
Detroit Lakes, MN 56501-3409
Phone (218) 847-5611

Hospital & facility affiliations

  • Essentia Health Home Care West Home health agency, Detroit Lakes, MN, CCN 248052
  • Essentia Health St Marys - Detroit Lakes Hospital, Detroit Lakes, MN, CCN 240101
  • Essentia Health Hospital, Fargo, ND, CCN 350070

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
67908MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Marys Regional Health Center Current Accepting new patients
St Mary'S Regional Health Center CurrentSince Sep 6, 2022 Accepting new patients
St Mary'S Regional Health Center CurrentSince Sep 6, 2022 Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

400 E 3rd St
#6
Duluth, MN 55805
Phone (320) 360-1676

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1003470048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013409",
            "telephone_number": "218-844-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LHOTKA",
        "first_name": "LAURA",
        "middle_name": "LOU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "67908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit Lakes, MN

Sources for this page

Verify at the official NPI Registry.