LOST LAKE OPTICAL COMPANY
NPI 1003434622
Clinic/Center in Mound, MN

Q: What is Lost Lake Optical Company's NPI number?

The NPI number for Lost Lake Optical Company is 1003434622. It was assigned to this organization in the NPPES registry on July 9, 2020.

Q: What is Lost Lake Optical Company's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since July 09, 2020

5240 SHADY ISLAND CIR, MOUND, MN 55364(612) 670-8887(952) 474-1933 Get Directions Write a Review

NPPES record last updated: September 4, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 4, 2020, Jul 9, 2020 (2 updates tracked since 2020).

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About Lost Lake Optical Company NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LOST LAKE OPTICAL COMPANY (NPI 1003434622) is a healthcare organization registered as a clinic/center in Mound, Minnesota and active in the NPI registry since July 2020. The organization lists Jay B. Petersen, Owner, as its authorized official.

NPPES Registry Identity

NPI1003434622

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameLOST LAKE OPTICAL COMPANY

Location Address5240 SHADY ISLAND CIRMound, MN 55364-9222

Mailing Address5240 Shady Island CirMound, MN 55364-9222 · (612) 670-8887 · Fax (952) 474-1933

Phone(612) 670-8887

Fax(952) 474-1933

Organization SubpartNo

Authorized OfficialJay B. PetersenOwner · (612) 670-8887

Enumeration DateJuly 9, 2020

Last NPPES UpdateSeptember 4, 20202 updates tracked since enumeration

NPPES CertifiedSeptember 4, 2020

✔ NPI 1003434622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

5240 SHADY ISLAND CIR, Mound, MN 55364

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lost Lake Optical Company's NPI number?

The NPI number for Lost Lake Optical Company is 1003434622. It was assigned to this organization in the NPPES registry on July 9, 2020.

Where is Lost Lake Optical Company located?

Lost Lake Optical Company is located at 5240 Shady Island Cir, Mound, MN 55364. The listed phone number is (612) 670-8887.

What is Lost Lake Optical Company's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

What insurance does Lost Lake Optical Company accept?

Health plans from Medica list Lost Lake Optical Company as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lost Lake Optical Company was last updated on September 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.