Lance Emil Gutfleisch, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2965 Issued in MN

Practice address

2000 NE Court
Bloomington, MN 55425-5506

Phone

(952) 853-1143

Fax

(952) 853-0591

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• LG Vision Services LLC

  • Optometrist
  • Fridley, MN
  • NPI 1588190961
  Medicare reassignment NPD Authorized official
• Advanced Eyecare, PC

  • Optometrist
  • Sioux Falls, SD
  • NPI 1417902743
  NPD (past)
• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861550741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 464",
            "city": "WASECA",
            "state": "MN",
            "postal_code": "560930464",
            "telephone_number": "952-465-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NE COURT",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554255506",
            "telephone_number": "952-853-1143",
            "fax_number": "952-853-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTFLEISCH",
        "first_name": "LANCE",
        "middle_name": "EMIL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "22-02832",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84M32GU",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "222525",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "A02161044528",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie Guski
• Alicia Gustafson, D.O.
• Mark Charles Gustafson, DC.
• Shane Michael Gustafson, DO
• Hope Katherine Gustason
• Abdalaziz Mohamed Hassan Guuled
• Jonathan Michael Guzman, MA, LPCC
• H.O.M.E. Program
• Michael Haag, PHARMD
• Ismahaan Haaji

• Optometrist in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.