Le Sueur Eyecare Center LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

LE SUEUR EYECARE CENTER LLC

Doing business as

Le Sueur Eyecare Center

Practice address

101 Main St S Ste 103
Le Sueur, MN 56058-7503

Phone

(507) 665-3366

Fax

(507) 665-3990

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Zachary Blake Dirks, ODNPI 1366640377

Title

Partner

Phone

(507) 469-9715

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• Le Sueur Eyecare Center Doing business as
• Mootz Eye Clinic PA Former legal business name

Medicare fee-for-service enrollment

Enrolled in MN3 enrollments

Enrollment records 3

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 4

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

• Zachary Blake Dirks, O.D.

  • Optometrist
  • Saint Peter, MN
  • NPI 1366640377
  Medicare reassignment Care Compare group NPD Authorized official
• Emma Panning, OD

  • Optometrist
  • Le Sueur, MN
  • NPI 1891535993
  Medicare reassignment Care Compare group NPD
• Britta Hansen Brown, OD

  • Optometrist
  • Monroe, WA
  • NPI 1053608240

  MN

  Medicare reassignment Care Compare group NPD
• Jeffrey Scott Mootz, OD

  • Optometrist
  • Le Sueur, MN
  • NPI 1417037730
  Medicare reassignment NPD

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1932268257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAIN ST S STE 103105",
            "city": "LE SUEUR",
            "state": "MN",
            "postal_code": "560587502",
            "telephone_number": "507-665-3366",
            "fax_number": "507-665-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN ST S STE 103",
            "city": "LE SUEUR",
            "state": "MN",
            "postal_code": "560587503",
            "telephone_number": "507-665-3366",
            "fax_number": "507-665-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LE SUEUR EYECARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "DIRKS",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "507-469-9715",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193518600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Le Sueur Eyecare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mootz Eye Clinic PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Mootz Eye Clinic PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Julie Johnson, LPN
• Asma Khalid Butler, MD
• Nicole Koukol
• Deborah Latzke, MS, LPCC, LADC
• Le Sueur Assisted Living
• Lesueur Family Dental
• Jaclyn Renee Lieske, COTA
• James F Logue, DC
• Midwest Foot and Ankle Specialists, LLC
• Minnesota Valley Health Center Inc

• Optometrist in Le Sueur, MN
• Providers in Le Sueur, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.