Individual provider Active NPI

Jeffery F Kneiert, OD

  • Optometrist
  • Fort Atkinson, WI
National Provider Identifier
1033160767
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2503-035 Issued in WI
Practice address
740 Reena Ave
Suite B
Fort Atkinson, WI 53538-3145
Phone
(920) 563-8468
Fax
(920) 563-0178
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2503-035 WI Primary

Addresses

Primary practice location

740 Reena Ave
Suite B
Fort Atkinson, WI 53538-3145

Mailing address

740 Reena Ave
Suite B
Fort Atkinson, WI 53538-3145
Phone (920) 563-8468

Other identifiers 1

IdentifierTypeStateIssuer
1033160767MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jkneiert261031@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20100508000131 WI Practitioner - Optometry 3577644053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1988
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)

740 Reena Ave
Fort Atkinson, WI 53538-3145
Phone (920) 563-0888

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2503-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc. CurrentSince Nov 1, 2014 Accepting new patients
Vision & Eye Health Associates, LLC Optometrist CurrentSince Jun 3, 2003 Accepting new patients
Vision & Eye Health Associates Optometrist Current Accepting new patients
Dean Health Systems, Inc CurrentSince Nov 1, 2014 Accepting new patients

Locations

703 14th St
Baraboo, WI 53913
Phone (608) 355-3800

1700 Tuttle St
Baraboo, WI 53913
Phone (608) 355-3800

1035 Pleasant St
Ste C
Beloit, WI 53511
Phone (608) 365-9591

740 Reena Ave
Ste B
Fort Atkinson, WI 53538
Phone (920) 563-8468

740 Reena Ave
Fort Atkinson, WI 53538
Phone (920) 563-0888

253 Center St
Ste 200
Lake Geneva, WI 53147
Phone (262) 248-9200

8800 US Highway 61
Lancaster, WI 53813
Phone (608) 723-2113

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

2825 Hunters Trl
Portage, WI 53901
Phone (608) 742-5522

100 N Main St
Richland Ctr, WI 53581
Phone (608) 647-8995

128 N Tratt St
Whitewater, WI 53190
Phone (262) 473-4514

Interoperability endpoints

  • Direct secure messaging: jkneiert261031@direct-ehr-ssmhc.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1033160767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 REENA AVE",
            "address_2": "SUITE B",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535383145",
            "telephone_number": "920-563-8468",
            "fax_number": "920-563-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 REENA AVE",
            "address_2": "SUITE B",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535383145",
            "telephone_number": "920-563-8468",
            "fax_number": "920-563-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEIERT",
        "first_name": "JEFFERY",
        "middle_name": "F",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2503-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033160767",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkneiert261031@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jkneiert261031@direct-ehr-ssmhc.com",
            "address_1": "740 Reena Ave",
            "address_2": "Suite B",
            "city": "Fort Atkinson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535383145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "740 Reena Ave",
            "address_2": "Suite B",
            "city": "Fort Atkinson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535383145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Atkinson, WI

Sources for this page

Verify at the official NPI Registry.