Individual provider Active NPI

Todd C Swanson, OD

  • Optometrist
  • Rice Lake, WI
National Provider Identifier
1063475879
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2907-035 Issued in WI
Practice address
2900 S Wisconsin Ave
Rice Lake, WI 54868-8578
Phone
(608) 341-9636
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2907-035 WI Primary
Optometrist 152W00000X 2907 WI

Addresses

Primary practice location

2900 S Wisconsin Ave
Rice Lake, WI 54868-8578

Mailing address

2900 S Wisconsin Ave
Rice Lake, WI 54868-8578
Phone (608) 341-9636

Other identifiers 3

IdentifierTypeStateIssuer
38620100MedicaidWI
1042571OtherWIPHYSICIANS PLUS
60180OtherWIDEAN HEALTH INSURANCE

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
I20040308000809 WI Practitioner - Optometry 4789572173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

341 E Lasalle Ave
PO Box 170
Barron, WI 54812-0170
Phone (715) 637-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2907-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dean M Springer Eyecare Inc Optometrist CurrentSince May 1, 2023 Accepting new patients
Dean M Springer Eyecare Inc Optometrist PastSince May 1, 2023 Accepting new patients
Gundersen Clinic LTD Past Accepting new patients
Dean Health Systems, Inc, Past Accepting new patients
Dean Health Systems, Inc. Past Accepting new patients

Locations

341 E La Salle Ave
Barron, WI 54812
Phone (715) 637-2020

231 US Highway 8 63
Turtle Lake, WI 54889
Phone (715) 986-4448

Organizations & group practices 5

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1063475879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S WISCONSIN AVE",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548688578",
            "telephone_number": "608-341-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S WISCONSIN AVE",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548688578",
            "telephone_number": "608-341-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "TODD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2907-035",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2907",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38620100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS PLUS",
            "identifier": "1042571",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "60180",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

Verify at the official NPI Registry.