LAKESIDE FAMILY EYE CARE
NPI 1164448627
Optometrist in Prior Lake, MN
About Lakeside Family Eye Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESIDE FAMILY EYE CARE (NPI 1164448627) is a healthcare organization registered as an optometrist in Prior Lake, Minnesota and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through January 19, 2028 and lists Lisa Anne Dawson-clausen, Owner/optometrist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 6
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lakeside Family Eye Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Lakeside Family Eye Care, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 24D2249464
Lakeside Family Eye Care · Prior Lake, MNFrequently 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 Crossroads Optometric Clinic, Inc.'s NPI number?
The NPI number for Crossroads Optometric Clinic, Inc. is 1164448627. It was assigned to this organization in the NPPES registry on July 15, 2006. The provider is doing business as Lakeside Family Eye Care.
Where is Crossroads Optometric Clinic, Inc. located?
Crossroads Optometric Clinic, Inc. is located at 16250 Duluth Ave SE Ste 100, Prior Lake, MN 55372. The listed phone number is (952) 447-2020.
What is Crossroads Optometric Clinic, Inc.'s specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Crossroads Optometric Clinic, Inc. enrolled in Medicare?
Yes. Crossroads Optometric Clinic, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Crossroads Optometric Clinic, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Optometry, reassign their Medicare billing to Crossroads Optometric Clinic, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Crossroads Optometric Clinic, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D2249464) is associated with this NPI, valid through January 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Crossroads Optometric Clinic, Inc. accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 5 other insurers list Crossroads Optometric Clinic, Inc. 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 Crossroads Optometric Clinic, Inc. was last updated on December 8, 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.
# Lakeside Family Eye Care · NPI 1164448627
Optometrist organization in Prior Lake, Minnesota. Organization record, active in the CMS NPPES registry since July 15, 2006.
## Identity
- **NPI:** 1164448627 (Entity type: Organization)
- **Enumerated:** July 15, 2006
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Legal business name:** Crossroads Optometric Clinic, Inc.
- **Organization subpart:** No
- **Authorized official:** Lisa Dawson-Clausen, OWNER/OPTOMETRIST
## Practice location
- **Address:** 16250 DULUTH AVE SE STE 100, Prior Lake, MN 55372-2883
- **Phone:** (952) 447-2020 · **Fax:** (952) 447-2322
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 8, 2020
- **Other identifiers:** Other 51154HI (MN); Other 92364 (MN); Other 2123989 (MN); and 3 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1164448627) · Data from the CMS NPPES public registry.