NPIMap

Organization Active NPI

Optometric Physicians LLC

  • Optometrist
  • Cottage Grove, MN
National Provider Identifier
1023283132
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1893 Issued in MN
Legal business name
OPTOMETRIC PHYSICIANS LLC
Practice address
9300 E Point Douglas Rd S
Cottage Grove, MN 55016-4030
Phone
(651) 846-2836
Fax
(952) 400-4207
NPI assigned
Apr 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Dr. Albert Ray LamotteNPI 1386626794
Title
Owner - Sole Member
Phone
(507) 385-8110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1893 MN Primary

Addresses

Primary practice location

9300 E Point Douglas Rd S
Cottage Grove, MN 55016-4030

Mailing address

1411 Adams St
Apt 101
Mankato, MN 56001
Phone (612) 701-7064

Other practice location 1

1752 N Frontage Rd
Hastings, MN 55033-3490
Phone (651) 438-5474

Other identifiers 1

IdentifierTypeStateIssuer
111460000MedicaidMN

National Provider Directory

National Provider Directory

Locations

1752 N Frontage Rd
Hastings, MN 55033
Phone (651) 438-2400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1023283132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 ADAMS ST",
            "address_2": "APT 101",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "612-701-7064",
            "fax_number": "952-400-4207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 E POINT DOUGLAS RD S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550164030",
            "telephone_number": "651-846-2836",
            "fax_number": "952-400-4207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1752 N Frontage Rd",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "MN",
            "postal_code": "550333490",
            "country_code": "US",
            "telephone_number": "651-438-5474",
            "fax_number": "952-400-4207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPTOMETRIC PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "LAMOTTE",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER - SOLE MEMBER",
        "authorized_official_telephone_number": "507-385-8110",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111460000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.