Gerald P Loushin, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

40569 Issued in MN

Practice address

12000 Elm Creek Blvd N Ste 100
Maple Grove, MN 55369-7074

Phone

(763) 416-7600

Fax

(763) 416-7634

NPI assigned

Jan 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Distinctive Eyewear, LLC

  • Optician
  • Golden Valley, MN
  • NPI 1457690133
  NPD (past)

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

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1063490928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 GOLDEN VALLEY RD STE 330",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274488",
            "telephone_number": "763-416-7629",
            "fax_number": "763-383-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 ELM CREEK BLVD N STE 100",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697074",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8501 Golden Valley Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Golden Valley",
            "state": "MN",
            "postal_code": "554274472",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 39th Ave NE Ste 1",
            "address_purpose": "LOCATION",
            "city": "St. Anthony",
            "state": "MN",
            "postal_code": "55421",
            "country_code": "US",
            "telephone_number": "763-416-7600",
            "fax_number": "763-416-7634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUSHIN",
        "first_name": "GERALD",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-02",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "40569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808816100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lopez Health Center, LLC
• Franklin Geovani Lopez, DC
• Alivia M Lor
• Shanice Lee Lorentz, RPH
• Caitlin Lorsung, MA, LPCC
• Anthony Louis Lovcik, O.D.
• Nicole T Lowe, M.D.
• Vicki Sue Luehmann, O.D.
• Renee Luehrs-Henson, RN
• Crystal Fialova Lumi, MD

• Ophthalmology Physician in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; 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.