Organization Active NPI

Lake Vision PLLC

  • Optometrist
  • Duluth, MN
National Provider Identifier
1285565069
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LAKE VISION PLLC
Practice address
2510 Maple Grove Rd Ste 500
Duluth, MN 55811-1829
Phone
(218) 722-2712
Fax
(218) 722-1011
NPI assigned
May 28, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Amy Walkowiak, ODNPI 1982265765
Title
Optometrist/Owner
Phone
(715) 817-4393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2510 Maple Grove Rd Ste 500
Duluth, MN 55811-1829

Mailing address

2510 Maple Grove Rd Ste 500
Duluth, MN 55811-1829
Phone (218) 722-2712

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1779926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1285565069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 MAPLE GROVE RD STE 500",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558111829",
            "telephone_number": "218-722-2712",
            "fax_number": "218-722-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 MAPLE GROVE RD STE 500",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558111829",
            "telephone_number": "218-722-2712",
            "fax_number": "218-722-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE VISION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-28",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "WALKOWIAK",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "715-817-4393",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.