Blade Aron Grupe, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3984 Issued in WI

Practice address

1626 Tuttle St Ste 1
Baraboo, WI 53913-1501

Phone

(608) 356-2020

Fax

(608) 355-7055

NPI assigned

Jan 30, 2022

Last updated

Sep 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in PA, WI2 enrollments

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 2

Specialty

Optometry

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bgrupe520945@direct-ehr-ssmhc.com

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.

• Dean Health Systems, Inc

  dba SSM Health Dean Medical Group

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846
  Medicare reassignment Care Compare group NPD
• Nittany Eye Associates LTD

  • Optometrist
  • State College, PA
  • NPI 1619071131
  Medicare reassignment NPD
• Dean Health Systems, Inc.

  dba SSM Health Davis Duehr Dean Eye Care - Portage

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

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

{
    "created_epoch": "1643500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1023761103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 S CHURCH ST",
            "city": "ALMA CENTER",
            "state": "WI",
            "postal_code": "546117711",
            "telephone_number": "715-896-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 TUTTLE ST STE 1",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131501",
            "telephone_number": "608-356-2020",
            "fax_number": "608-355-7055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "428 Windmere Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168017644",
            "country_code": "US",
            "telephone_number": "814-234-2015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUPE",
        "first_name": "BLADE",
        "middle_name": "ARON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-30",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003891",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023761103",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1626 Tuttle St Ste 1",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539131501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bgrupe520945@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "address_1": "1626 Tuttle St Ste 1",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539131501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thomas Graber, APSW
• Jennifer L Gramer, APNP
• Ottilie Gramling, OTR
• Karen Lynn Green, M.A., CCC-SLP
• Greenbriar Apartments, LLC
• Helen L Gudlewski, RN
• Lisa Guzman
• Bailey R Haas, PA-C
• Heather Renee Haas, M.S., LMFT
• Diane L. Hadsell, P.T.

• Optometrist in Baraboo, WI
• Providers in Baraboo, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.