Long Lake Eye Llc is a medicare enrolled "Optometrist" provider in Long Lake, Minnesota. Their current practice location is
1916 W Wayzata Blvd Ste 2, Long Lake, Minnesota. You can reach out to their office (for appointments etc.) via phone at
(612) 366-9808.
Long Lake Eye Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Long Lake Eye Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1225998792.
Healthcare Provider's Profile
| Full Name | Long Lake Eye Llc |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 1916 W Wayzata Blvd Ste 2, Long Lake, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1225998792
- Provider Enumeration Date: 11/17/2025
- Last Update Date: 03/01/2026
Medicare PECOS Information:
- PECOS PAC ID: 7012484033
- Enrollment ID: O20260428001315
Medical Identifiers
Medical identifiers for Long Lake Eye Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1225998792 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Long Lake Eye Llc acts as a billing entity for following providers:
| Provider Name | Matthew Tyrell Lepage |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1225740327
PECOS PAC ID: 9133590854
Enrollment ID: I20230117001688 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Long Lake Eye Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Long Lake Eye Llc
202 N Cedar Ave Ste 1,
Owatonna, MN 55060-2306
Ph: (612) 366-9808 | Long Lake Eye Llc
1916 W Wayzata Blvd Ste 2,
Long Lake, MN 55356-9559
Ph: (612) 366-9808 |
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