Birch Lake Vision Group, LLC.
NPI 1609921899ActiveOrganization· Optometrist· White Bear Lake, MN
Optometrist in White Bear Lake, Minnesota, registered in NPPES in January 2007. The authorized official on file is Brian Dwight Grudem, O.D., Cfo.
Overview
| NPI | 1609921899 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 25, 2007 |
| Last updated in NPPES | Dec 2, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | LD1732000 | MN |
| Optometrist | 152W00000X | LD2695000 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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