Zachary Lundgren, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3339 Issued in CO

Practice address

1603 Southbrook LN
Wadena, MN 56482-2110

Phone

(218) 371-7022

NPI assigned

Apr 1, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southlands Vision AssociatesGroup PAC ID 6709880792, 5 clinicians

Altitude Eye CareGroup PAC ID 2365778065, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Altitude Eye Care

  • Optometrist
  • Lone Tree, CO
  • NPI 1235797796
  Medicare reassignment Care Compare group NPD
• Southlands Vision Associates

  • Optometrist
  • Aurora, CO
  • NPI 1184645178
  Medicare reassignment Care Compare group NPD
• Altitude Eye Care at Castlerock, PLLC

  • Optometrist
  • Castle Rock, CO
  • NPI 1679187850
  Medicare reassignment NPD

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1013370535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 SOUTHBROOK LN",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564822110",
            "telephone_number": "218-371-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 SOUTHBROOK LN",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564822110",
            "telephone_number": "218-371-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "3339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Elizabeth Lindblom, PHARMD
• Macayla Rose Lindenfelser, NP-C
• Rose Ann Lorentz, A-G NP
• LSS Home Health and Hospice, LLC
• LSS of Wadena, LLC
• Elizabeth Marie Marshall, OD
• Brooke Martinez, M.S. LMFT
• James H Matthiae, DDS
• Tori Corrine Ione McDougald
• Mertens Drug Inc

• Optometrist in Wadena, MN
• Providers in Wadena, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.