Long Lake Eye LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

LONG LAKE EYE LLC

Practice address

1916 W Wayzata Blvd Ste 2
Long Lake, MN 55356-9559

Phone

(612) 366-9808

NPI assigned

Nov 17, 2025

Last updated

Mar 1, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Lepage, ODNPI 1225740327

Title

Optometrist / Owner

Phone

(612) 366-9808

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

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.

• Matthew Lepage, OD

  • Optometrist
  • Saint Paul, MN
  • NPI 1225740327
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1763337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772323200000",
    "number": "1225998792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N CEDAR AVE STE 1",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550602306",
            "telephone_number": "612-366-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 W WAYZATA BLVD STE 2",
            "city": "LONG LAKE",
            "state": "MN",
            "postal_code": "553569559",
            "telephone_number": "612-366-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG LAKE EYE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-17",
        "last_updated": "2026-03-01",
        "certification_date": "2026-03-01",
        "status": "A",
        "authorized_official_last_name": "LEPAGE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OPTOMETRIST / OWNER",
        "authorized_official_telephone_number": "612-366-9808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Long Lake, MN
• Providers in Long Lake, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.