Clear Lake Optics Corp

Primary specialty

OptometristTaxonomy code 152W00000X

License

02146 Issued in IA

Legal business name

CLEAR LAKE OPTICS CORP

Doing business as

Michael L Korthals

Practice address

422 S Pierce Ave Ste 100a
Mason City, IA 50401-2709

Phone

(641) 424-0780

Fax

(641) 424-2345

NPI assigned

Sep 5, 2007

Last updated

Dec 14, 2023By 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. Mike L Korthals

Title

Owner

Phone

(641) 424-0780

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Michael L Korthals Doing business as

Medicare fee-for-service enrollment

Enrolled in IA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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.

• Bradley Boyle, O.D.

  • Optometrist
  • Independence, IA
  • NPI 1255781068
  Medicare reassignment NPD
• Michael L Korthals, O.D.

  • Optometrist
  • Mason City, IA
  • NPI 1407880883
  Medicare reassignment NPD

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1679767339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 S PIERCE AVE STE 100A",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012709",
            "telephone_number": "641-424-0780",
            "fax_number": "641-424-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 S PIERCE AVE STE 100A",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012709",
            "telephone_number": "641-424-0780",
            "fax_number": "641-424-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR LAKE OPTICS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "KORTHALS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "641-424-0780",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "35096",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1204016",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB8928",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael L Korthals",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Michael L Korthals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Torrie A Chizek, ATC, CSCS
• Mary Brigid Christianson, LISW, RPT-S
• Vaughan Robert Cipperly, MD
• City of Mason City (Mason City Fire & Rescue)
• Clark and Associates, Inc
• Clear View Eye Clinic, Inc
• Kasey K Clowe, M.D.
• Courtney Cockrum
• James K Coddington, MD
• Marie E Cole, ARNP

• Optometrist in Mason City, IA
• Providers in Mason City, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.