Mark Lobanoff, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

207W00000X Issued in MN

Practice address

6099 Wayzata Blvd Ste 100-120
St Louis Park, MN 55416-5538

Phone

(952) 204-5060

Fax

(952) 204-9060

NPI assigned

Jun 15, 2006

Last updated

Jun 28, 2023By the provider in NPPES

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

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ovo Lasik and Lens LLCGroup PAC ID 8921497751, 7 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ovo Lasik and Lens LLC

  • Ophthalmology Physician
  • St Louis Park, MN
  • NPI 1770259087
  Medicare reassignment Care Compare group NPD Authorized official
• North Suburban Eye Specialists, LLP

  • Ophthalmology Physician
  • Coon Rapids, MN
  • NPI 1689870156
  NPD
• North Suburban Optical

  dba Optical Studios

  • Eyewear Supplier
  • Coon Rapids, MN
  • NPI 1730386723
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1205870045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6099 WAYZATA BLVD STE 100-120",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165538",
            "telephone_number": "952-204-5060",
            "fax_number": "952-204-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6099 WAYZATA BLVD STE 100-120",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165538",
            "telephone_number": "952-204-5060",
            "fax_number": "952-204-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOBANOFF",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "207W00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Lineer, MD
• Laura Linner, A.M., LICSW
• Elina Lipovskiy, D.O.
• Heidie Lish, MPH, RD
• Melissa R Livingston, OTR/L
• Kaitlyn Locker
• George Logan
• William Gerald Loomis, D.C.
• Loon Lake Living Care Inc
• Sarah Loots, CRNA

• Ophthalmology Physician in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.