Active NPI
Anthony Louis Lovcik, O.D.
- Optometrist
- Maple Grove, MN
National Provider Identifier
1205971975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- MN2638
- Practice address
- 12131 Elm Creek Blvd N
Maple Grove, MN 55369-7093 - Phone
- (763) 416-1983
- Fax
- (763) 416-4084
- NPI assigned
- Feb 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | MN2638 | MN | Primary |
Addresses
Primary practice location
12131 Elm Creek Blvd N
Maple Grove, MN 55369-7093
Mailing address
7516 Mariner Dr
Maple Grove, MN 55311-2613
Phone (763) 420-6647
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP37578 | Other | FM | HEALTH PARTNERS |
| 219101031048 | Other | MN | PREFFERED |
| 60P14L0 | Other | MN | BCBS |
| 2124155 | Other | FM | AMERICAS PPO |
| 2202189 | Other | MN | MEDICA |
| 2202456 | Other | MN | MEDICA BROOKDALE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MN2638 | MN | MD | Optometrist |
| 2638 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| L.C. Optometric P.C. | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Maple Grove, MN
- NPI 1811191513
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1205971975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7516 MARINER DR",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553112613",
"telephone_number": "763-420-6647",
"fax_number": "763-416-4084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12131 ELM CREEK BLVD N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553697093",
"telephone_number": "763-416-1983",
"fax_number": "763-416-4084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVCIK",
"first_name": "ANTHONY",
"middle_name": "LOUIS",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "MN2638",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP37578",
"state": "FM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFFERED",
"identifier": "219101031048",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "60P14L0",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAS PPO",
"identifier": "2124155",
"state": "FM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "2202189",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA BROOKDALE",
"identifier": "2202456",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.