Busisiwe Rose Vandriel, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3085-035 Issued in WI

Practice address

200 S 18TH Ave
Wausau, WI 54401-4252

Phone

(715) 842-8040

Fax

(715) 848-8773

NPI assigned

Aug 23, 2007

Last updated

Jul 29, 2014By the provider in NPPES

Sex

Female

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

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shoptikal LLC

  dba Shopko Optical 4002

  • Eyewear Supplier
  • Green Bay, WI
  • NPI 1659937159

  Optometrist

  Medicare reassignment Care Compare group NPD
• Shoptikal LLC

  dba Shopko Optical 4037

  • Eyewear Supplier
  • Chippewa Falls, WI
  • NPI 1598321960

  Optometrist

  NPD
• Shoptikal LLC

  dba Fielmann Vision Care 4313

  • Eyewear Supplier
  • Rockford, IL
  • NPI 1467311142

  Optometrist

  NPD
• Shopko Stores Operating Co LLC

  dba ShopKo Pharmacy 024

  • Community/Retail Pharmacy
  • Eau Claire, WI
  • NPI 1720034176
  NPD (past)

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1043403967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S 18TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014252",
            "telephone_number": "715-842-8040",
            "fax_number": "715-848-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S 18TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014252",
            "telephone_number": "715-842-8040",
            "fax_number": "715-848-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDRIEL",
        "first_name": "BUSISIWE",
        "middle_name": "ROSE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3085-035",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3081",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "00004168",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38632500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly Ann Van de Weerd, RN
• Bethany Van Dong, MS CCC-SLP
• Laura M. Van Ryn, PA-C
• Karen Vandenberg, PT
• Kelsey Vandenberg, DNP, APNP, AGNP-C
• Mai See Vang Yang, R.N.
• Abby Vang
• Nancy L Vang
• Tou Vang
• Yia Vang, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.