Individual provider Active NPI

Bryan David Lorenz, OD

  • Optometrist
  • Saint Cloud, MN
National Provider Identifier
1881634806
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2694 Issued in MN
Practice address
4161 2ND St S
Shopko Optical
Saint Cloud, MN 56301-3761
Phone
(320) 253-5994
Fax
(320) 253-5790
NPI assigned
Jun 7, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2694 MN Primary

Addresses

Primary practice location

4161 2ND St S
Shopko Optical
Saint Cloud, MN 56301-3761

Mailing address

4161 2ND St S
Shopko Optical
Saint Cloud, MN 56301-3761
Phone (320) 253-5994

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060714000276 MN Practitioner - Optometry 3476566464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

1004 18TH Ave NW
Suite D
Austin, MN 55912-1993
Phone (507) 437-8228

4051 W Division St
Suite a
Saint Cloud, MN 56301-3741
Phone (320) 253-5994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2694MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist CurrentSince May 16, 2019 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince May 16, 2019 Accepting new patients

Locations

1004 18th Ave NW
Ste D
Austin, MN 55912
Phone (507) 437-8228

4161 2nd St S
Saint Cloud, MN 56301
Phone (320) 253-3280

501 Highway 10 S
Saint Cloud, MN 56304
Phone (320) 253-4695

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1881634806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4161 2ND ST S",
            "address_2": "SHOPKO OPTICAL",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013761",
            "telephone_number": "320-253-5994",
            "fax_number": "320-253-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 2ND ST S",
            "address_2": "SHOPKO OPTICAL",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013761",
            "telephone_number": "320-253-5994",
            "fax_number": "320-253-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZ",
        "first_name": "BRYAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.