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VANDESTEEG & LARSON OPTOMETRIC CLINIC, PA
NPI 1174929160
Eyewear Supplier in Glenwood, MN

Active since November 18, 2014
24 1ST ST SE, GLENWOOD, MN 56334(320) 634-4516(320) 634-4520 Get Directions Write a Review

NPPES record last updated: July 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 29, 2022, Apr 14, 2022 (2 updates tracked since 2022).

About Vandesteeg & Larson Optometric Clinic, Pa NPPES

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

VANDESTEEG & LARSON OPTOMETRIC CLINIC, PA (NPI 1174929160), doing business as Glacial Ridge Eye Clinic, is a healthcare organization registered as an eyewear supplier in Glenwood, Minnesota and active in the NPI registry since November 2014. The organization lists Jonathan D Larson, Owner, as its authorized official.

NPPES Registry Identity

NPI1174929160
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameVANDESTEEG & LARSON OPTOMETRIC CLINIC, PA
Location Address24 1ST ST SEGlenwood, MN 56334-1619
Mailing Address24 1st Street SeGlenwood, MN 56334 · (320) 634-4516 · Fax (320) 634-4520
Phone(320) 634-4516
Fax(320) 634-4520
Organization SubpartNo
Authorized OfficialJonathan D LarsonOwner · (320) 634-4516
Enumeration DateNovember 18, 2014
Last NPPES UpdateJuly 16, 20252 updates tracked since enumeration
NPPES CertifiedJuly 16, 2025
✔ NPI 1174929160 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
24 1ST ST SE, Glenwood, MN 56334
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Other Names 1

Doing Business AsGlacial Ridge Eye Clinic

Other Identifiers 2

Medicaid10000202944MN
Medicaid496063700MN

Accepted Insurance

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

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. CRAIG D DEJONG O.D.
Optometrist
24 1ST ST SE, GLACIAL RIDGE EYE CLINIC, INC
GLENWOOD, MN 56334
Pope County (320) 634-4516
GLACIAL RIDGE EYE CLINIC, INC.
Optometrist
24 1ST ST SE
GLENWOOD, MN 56334
Pope County (320) 634-4516
VANDESTEEG & LARSON OPTOMETRIC CLINIC PA
Optometrist
24 1ST ST SE
GLENWOOD, MN 56334
Pope County (320) 634-4516

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 Vandesteeg & Larson Optometric Clinic, PA's NPI number?

The NPI number for Vandesteeg & Larson Optometric Clinic, PA is 1174929160. It was assigned to this organization in the NPPES registry on November 18, 2014. The provider is doing business as Glacial Ridge Eye Clinic.

Where is Vandesteeg & Larson Optometric Clinic, PA located?

Vandesteeg & Larson Optometric Clinic, PA is located at 24 1st St SE, Glenwood, MN 56334. The listed phone number is (320) 634-4516.

What is Vandesteeg & Larson Optometric Clinic, PA's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

What insurance does Vandesteeg & Larson Optometric Clinic, PA accept?

Health plans from Medica list Vandesteeg & Larson Optometric Clinic, PA 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 Vandesteeg & Larson Optometric Clinic, PA was last updated on July 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.