Individual provider Active NPI

Peter Michael Kolar, O.D.

  • Optometrist
  • Nekoosa, WI
National Provider Identifier
1023176971
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2771 Issued in WI
Practice address
404 Market St
Nekoosa, WI 54457-1126
Phone
(715) 886-4731
Fax
(715) 886-4706
NPI assigned
Dec 4, 2006
Last updated
Apr 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2771 WI Primary

Addresses

Primary practice location

404 Market St
Nekoosa, WI 54457-1126

Mailing address

404 Market St
Nekoosa, WI 54457-1126
Phone (715) 886-4731

Other identifiers 1

IdentifierTypeStateIssuer
38607400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080314000523 WI Practitioner - Optometry 4385729367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

404 Market St
Nekoosa, WI 54457-1126
Phone (715) 886-4731

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2771WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kolar Optometric, LLC Optometrist CurrentSince May 1, 2000 Accepting new patients
Kolar Optometric, LLC Optometrist CurrentSince May 1, 2000 Accepting new patients

Locations

404 Market St
Nekoosa, WI 54457
Phone (715) 886-4731

8243 Jackson St
Pittsville, WI 54466
Phone (715) 884-2030

Interoperability endpoints

  • Direct secure messaging: peter.kolar@kolarvision.direct.eyemdemr.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1023176971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 MARKET ST",
            "city": "NEKOOSA",
            "state": "WI",
            "postal_code": "544571126",
            "telephone_number": "715-886-4731",
            "fax_number": "715-886-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 MARKET ST",
            "city": "NEKOOSA",
            "state": "WI",
            "postal_code": "544571126",
            "telephone_number": "715-886-4731",
            "fax_number": "715-886-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLAR",
        "first_name": "PETER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38607400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nekoosa, WI

Sources for this page

Verify at the official NPI Registry.