Individual provider Active NPI

Kristie Lynn Andrews, O.D.

  • Optometrist
  • Howards Grove, WI
National Provider Identifier
1073996633
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3384-35 Issued in WI
Practice address
300 Audubon Rd
Howards Grove, WI 53083-1288
Phone
(920) 565-3991
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3384-35 WI Primary

Addresses

Primary practice location

300 Audubon Rd
Howards Grove, WI 53083-1288

Mailing address

300 Audubon Rd
Howards Grove, WI 53083-1288
Phone (920) 565-3991

Other identifiers 1

IdentifierTypeStateIssuer
1619065224OtherWIORGANIZATION (EMPLOYER) NPI

Other names 1

  • Dr. Kristie Lynn Thieme Former name

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
I20151228001844 WI Practitioner - Optometry 5991006405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David W Kisiolek OD SCGroup PAC ID 7214934587, 2 clinicians
Viktor and Mariya LLCGroup PAC ID 8224519012, 2 clinicians

Practice addresses (Care Compare)

300 Audubon Rd
Howards Grove, WI 53083-1288
Phone (920) 565-3991

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Viktor & Mariya, LLC Optometrist CurrentSince Jan 1, 2026 Accepting new patients
David W. Kisiolek, O.D., S.C. Optometrist CurrentSince Sep 10, 2018 Accepting new patients
Shopko Stores Operating Co LLC Past Accepting new patients

Locations

300 Audubon Rd
Sheboygan, WI 53083
Phone (920) 565-3991

Organizations & group practices 3

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1073996633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 AUDUBON RD",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831288",
            "telephone_number": "920-565-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 AUDUBON RD",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831288",
            "telephone_number": "920-565-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "KRISTIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3384-35",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION (EMPLOYER) NPI",
            "identifier": "1619065224",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIE",
            "last_name": "THIEME",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Howards Grove, WI

Sources for this page

Verify at the official NPI Registry.