NPIMap

Organization Active NPI

L.C. Optometric P.C.

  • Optometrist
  • Maple Grove, MN
National Provider Identifier
1811191513
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2638 Issued in MN
Legal business name
L.C. OPTOMETRIC P.C.
Practice address
12131 Elm Creek Blvd N
Maple Grove, MN 55369-7093
Phone
(763) 416-1983
Fax
(763) 416-4084
NPI assigned
Jun 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Anthony Lovcik, O.D.NPI 1205971975
Title
Owner
Phone
(763) 416-1983

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
Optometrist 152W00000X 2638 MN Primary

Addresses

Primary practice location

12131 Elm Creek Blvd N
Maple Grove, MN 55369-7093

Mailing address

12131 Elm Creek Blvd N
Maple Grove, MN 55369-7093
Phone (763) 416-1983

Other identifiers 3

IdentifierTypeStateIssuer
96531OtherMNHEALTH PARTNERS GROUP NUM
1204389OtherMNAETNA
60P13LOOtherMNBLUE CROSS GROUP NUMBER

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811191513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": {
        "organization_name": "L.C. OPTOMETRIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOVCIK",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-416-1983",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS GROUP NUM",
            "identifier": "96531",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1204389",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "60P13LO",
            "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 Aug 22, 2020; 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.