DR. KEVIN DAVID LUCAS (NPI# 1407848427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407848427 |
| Entity Type | Individual |
| Full Name | DR. KEVIN DAVID LUCAS |
| Credential | O.D. |
| Practice Address |
4720 White Bear Pkwy White Bear Lake MN 55110-3336 |
| Practice Telephone | 6514262747 |
| Practice Fax Number | 6514269838 |
| Mailing Telephone | 6514262747 |
| Mailing Fax Number | 6514269838 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | LD2695000 | MN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICA | 22-02780 | 01 |
| MN | HEALTH PARTNERS | HP27080 | 01 |
| MN | MEDICARE RAILROAD RETIREM | P00116310 | 01 |
| MN | MEDICA | 22-01733 | 01 |
| MN | PREFERRED ONE | 965401019270 | 01 |
| MN | BLUE CROSS BLUE SHIELD | 244R0LU | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528457470 | Kevin Lucas | Dentist | 1401 Mchenry Rd Ste 221, Buffalo Grove, IL 60089-1384 | 2015-01-15 |
| 1053466375 | Kevin Timothy Lucas | Occupational Therapist | 3102 Nw Alberta, Bentonville, AR 72712-8428 | 2007-01-25 |
| 1124168323 | Kevin Joseph Lucas | Massage Therapist | 12615 E Mission Ave, Suite 400, Spokane Valley, WA 99216-1047 | 2007-02-07 |
| Street Address |
4720 WHITE BEAR PKWY |
| City | WHITE BEAR LAKE |
| State | MN |
| Zip Code | 55110-3336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194717298 | Brian Dwight Grudem | Optometrist | 4720 White Bear Pkwy, White Bear Lake, MN 55110-3336 | 2005-08-16 |
| 1700115409 | Brad Elliot Schwantke | Optometrist | 4720 White Bear Pkwy, White Bear Lake, MN 55110-3336 | 2009-12-09 |
| 1609921899 | Birch Lake Vision Group, LLC. | Optometrist | 4720 White Bear Pkwy, White Bear Lake, MN 55110-3336 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467071084 | St. Catherine University School Based Health Clinic | Nurse Practitioner | 5045 Division Ave, White Bear Lake, MN 55110 | 2020-04-14 |
| 1922450618 | Lisa Marie Thatcher | Podiatrist | 4653 White Bear Pkwy., St. Paul, MN 55110 | 2016-07-06 |
| 1558725598 | White Bear Dentists, PC | Dentist | 1970 Buerkle Road, White Bear Lake, MN 55110 | 2016-04-06 |
| 1124486246 | Julie Blaske | Counselor | 1310 Hwy 96 E, Suite 200, White Bear Lake, MN 55110 | 2016-02-03 |
| 1851761514 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1920 Buerkle Rd, White Bear Lake, MN 55110 | 2015-10-06 |
| 1821496969 | Leah Eichmiller | Acupuncturist | 2183 3rd Street, C/o Indulge Salon, White Bear Lake, MN 55110 | 2014-12-05 |
| 1447672084 | Ashley Rath | Chiropractor | 1247 Gun Club Rd., White Bear Lake, MN 55110 | 2014-01-16 |
| 1790121291 | Advanced Medical Home Care, LLC | Home Health | 2555 County Road E East, Suite 101, White Bear Lake, MN 55110 | 2013-05-11 |
| 1134468465 | Emergency Physicians Professional Association | Clinic/Center | 1159 E. County Road E, Vadnais Heights, MN 55110 | 2013-02-06 |
| 1639444284 | Rebecca Lynn Blaede | Counselor | 4858 Banning Avenue, White Bear Lake, MN 55110 | 2012-03-15 |
| Find all providers in zip 55110 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134368863 | Paul Christopher Onderick | Optometrist | 3827 White Bear Ave N, White Bear Lake, MN 55110-4767 | 2009-02-19 |
| 1053360701 | Jaclyn Elizabeth Doffin | Optometrist | 4750 Washington Sq, White Bear Lake, MN 55110-3257 | 2006-05-09 |
| 1194717298 | Brian Dwight Grudem | Optometrist | 4720 White Bear Pkwy, White Bear Lake, MN 55110-3336 | 2005-08-16 |
| 1700115409 | Brad Elliot Schwantke | Optometrist | 4720 White Bear Pkwy, White Bear Lake, MN 55110-3336 | 2009-12-09 |
| 1609921899 | Birch Lake Vision Group, LLC. | Optometrist | 4720 White Bear Pkwy, White Bear Lake, MN 55110-3336 | 2007-01-25 |
| 1427000397 | Elizabeth A Roberts | Optometrist | 4750 Washington Sq, White Bear Lake, MN 55110-3257 | 2006-05-17 |
| 1588615413 | Allyson K Caspers | Optometrist | 4750 Washington Sq, White Bear Lake, MN 55110-3257 | 2006-05-15 |
| 1346291630 | Doffin Family Eye Care Pa | Optometrist | 4750 Washington Sq, White Bear Lake, MN 55110-3257 | 2006-05-12 |
| 1740230580 | David Michael Perry | Optometrist | 4750 Washington Sq, White Bear Lake, MN 55110-3257 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615069 | Eagan Eye Clinic LLC | Optometrist | 12390 Sherburne Ave, Becker, MN 55308-9147 | 2020-10-02 |
| 1750998100 | Infinity Eye Care | Optometrist | 1275 Ramsey St Ste 700, Shakopee, MN 55379-3131 | 2020-09-29 |
| 1831700798 | Muychi Timothy Vang | Optometrist | 11217 Commerce Dr N, Champlin, MN 55316-3122 | 2020-08-13 |
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1699399592 | Nicole Rene Schmiedt | Optometrist | 400 Selby Ave Apt 221, Saint Paul, MN 55102-4509 | 2020-06-05 |
| 1700409885 | Russell N Osnes Od & Associates Pa | Optometrist | 1340 Duckwood Dr Ste 14, Eagan, MN 55123-2324 | 2020-05-22 |
| 1225657067 | Viginia Ho | Optometrist | 680 County Road 10 Ne, Blaine, MN 55434-2329 | 2020-04-12 |
| 1992331359 | Megan Kaye Horter | Optometrist | 1 Veterans Dr # 100-77, Minneapolis, MN 55417-2309 | 2020-03-18 |
| 1639704232 | Barton Eye Care LLC | Optometrist | 2306 S Broadway St Ste 12, Alexandria, MN 56308-1883 | 2020-03-04 |
| Find all providers with the same taxonomy | ||||
| City | WHITE BEAR LAKE |
| Zip Code | 55110 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.