Individual provider Active NPI

Taylor Lauermann, OD

  • Optometrist
  • Woodbury, MN
National Provider Identifier
1083238836
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3683 Issued in MN
Practice address
2070 Eagle Creek LN
Woodbury, MN 55129-3216
Phone
(651) 436-3356
NPI assigned
Jun 7, 2020
Last updated
Feb 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3683 MN Primary

Addresses

Primary practice location

2070 Eagle Creek LN
Woodbury, MN 55129-3216

Mailing address

1372 Margaret St
Saint Paul, MN 55106-4814
Phone (320) 761-0185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20201021000572 MN Practitioner - Optometry 8527488121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagan Eye Clinic LLCGroup PAC ID 0345220745, 48 clinicians

Practice addresses (Care Compare)

2070 Eagle Creek LN
Suite 200
Woodbury, MN 55129-3217
Phone (651) 436-3356

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eagan Eye Clinic LLC Optometrist CurrentSince Jan 1, 2021 Accepting new patients
Eagan Eye Clinic LLC Optometrist CurrentSince Jan 1, 2021 Accepting new patients
Optometric Services, LLC Optometrist CurrentSince Jul 9, 2020 Accepting new patients

Locations

1270 Promenade Pl
Ste 120
Eagan, MN 55121
Phone (651) 451-1805

2716 Lincoln Dr
Saint Paul, MN 55113
Phone (651) 631-9394

3930 Cedar Grove Pkwy
Saint Paul, MN 55122
Phone (612) 454-5661

7011 10th St N
Saint Paul, MN 55128
Phone (651) 738-8040

1891 Robert St S
West St Paul, MN 55118
Phone (651) 451-1805

2070 Eagle Creek Ln
Ste 200
Woodbury, MN 55129
Phone (651) 436-3356

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1591488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1083238836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1372 MARGARET ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551064814",
            "telephone_number": "320-761-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 EAGLE CREEK LN",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551293216",
            "telephone_number": "651-436-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUERMANN",
        "first_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-07",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.