Organization Active NPI

Stoughton Eye Care & Eyewear LLC

  • Optometrist
  • Stoughton, WI
National Provider Identifier
1043665482
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
STOUGHTON EYE CARE & EYEWEAR LLC
Practice address
2300 US Highway 51 and 138
Suite E
Stoughton, WI 53589-2080
Phone
(608) 205-2293
Fax
(608) 205-6813
NPI assigned
May 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Authorized official

Name
Dr. Andrew James Lindell, O.D.NPI 1942593389
Title
Optometrist
Phone
(231) 920-5729

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2300 US Highway 51 and 138
Suite E
Stoughton, WI 53589-2080

Mailing address

2300 US Highway 51 and 138
Suite E
Stoughton, WI 53589-2080
Phone (608) 205-2293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160622002421 WI Part B Supplier - Clinic/Group Practice 0042509242 Receives reassigned benefits from 2 practitioners
Practice locations: Stoughton, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2151588Stoughton Eye Care & Eyewear, LLC2300 US Hwy 51 and 138, Ste E, Stoughton, WI 53589Certificate of waiverJul 22, 2028

National Provider Directory

National Provider Directory

Locations

2300 US Highway 51 and 138
Ste E
Stoughton, WI 53589
Phone (608) 205-2293

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1043665482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 US HIGHWAY 51 AND 138",
            "address_2": "SUITE E",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535892080",
            "telephone_number": "608-205-2293",
            "fax_number": "608-205-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 US HIGHWAY 51 AND 138",
            "address_2": "SUITE E",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535892080",
            "telephone_number": "608-205-2293",
            "fax_number": "608-205-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOUGHTON EYE CARE & EYEWEAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "LINDELL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "231-920-5729",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.