RIVER LAKE CLINIC LLC
RIVER LAKE CLINIC LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1902932965, based in Minneapolis, MN. The organization lists 13 taxonomy classifications, with Optometrist recorded as primary.
Getting there
The practice address on file is 4323 E LAKE ST, Minneapolis, MN 55406. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 1652 | MN | Optometrist primary |
| 1652 | MN | Occupational Vision Optometrist |
| 1652 | MN | Vision Therapy Optometrist |
| 3331 | MN | Optometrist |
| 3331 | MN | Corneal and Contact Management Optometrist |
| 3331 | MN | Low Vision Rehabilitation Optometrist |
| 3331 | MN | Pediatric Optometrist |
| 3331 | MN | Sports Vision Optometrist |
| LP2754 | MN | Psychologist |
| LP2754 | MN | Family Psychologist |
| LP2754 | MN | Counseling Psychologist |
| LP2754 | MN | Adult Development & Aging Psychologist |
| LP2754 | MN | Cognitive & Behavioral Psychologist |
| LP2754 | MN | Forensic Psychologist |
This provider holds licence 1652 issued in MN. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 3173749322
- Enrollment ID
- O20140723001701
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Optometrist covers
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. NUCC Health Care Provider Taxonomy, code 152W00000X
All registered taxonomy codes
This provider registers 14 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 152W00000X | Optometrist | 1652 | MN | primary |
| 152WX0102X | Occupational Vision Optometrist Occupational Vision | 1652 | MN | |
| 152WV0400X | Vision Therapy Optometrist Vision Therapy | 1652 | MN | |
| 152W00000X | Optometrist | 3331 | MN | |
| 152WC0802X | Corneal and Contact Management Optometrist Corneal and Contact Management | 3331 | MN | |
| 152WL0500X | Low Vision Rehabilitation Optometrist Low Vision Rehabilitation | 3331 | MN | |
| 152WP0200X | Pediatric Optometrist Pediatrics | 3331 | MN | |
| 152WS0006X | Sports Vision Optometrist Sports Vision | 3331 | MN | |
| 103T00000X | Psychologist | LP2754 | MN | |
| 103TF0000X | Family Psychologist Family | LP2754 | MN | |
| 103TC1900X | Counseling Psychologist Counseling | LP2754 | MN | |
| 103TA0700X | Adult Development & Aging Psychologist Adult Development & Aging | LP2754 | MN | |
| 103TB0200X | Cognitive & Behavioral Psychologist Cognitive & Behavioral | LP2754 | MN | |
| 103TF0200X | Forensic Psychologist Forensic | LP2754 | MN |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1902932965 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Feb 26, 2007 |
| Last updated | Jan 30, 2014 |
| Status | Active |
| Practice address |
4323 E LAKE ST Minneapolis, MN 55406 (612) 722-1003 Fax (612) 721-6336 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 9 | 0 | 2 | 9 | 3 | 2 | 9 | 6 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 9 | 0 | 2 | 9 | 3 | 4 | 9 | 3 |
Sum = 65 · next multiple of 10 = 70 · check digit = 5 · actual last digit = 5
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.