Individual provider Active NPI

Brooke Sosalla, OD

  • Optometrist
  • Eau Claire, WI
National Provider Identifier
1083392088
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3994 Issued in WI
Practice address
733 W Clairemont
Eau Claire, WI 54701
Phone
(715) 838-5222
NPI assigned
Jul 10, 2023
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3994 WI Primary
Optometrist 152W00000X 0003944 CO

Addresses

Primary practice location

733 W Clairemont
Eau Claire, WI 54701

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

11960 Lioness Way Ste 190
Parker, CO 80134-5640
Phone (303) 794-1111

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
I20240904001844 WI Practitioner - Optometry 4981144003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, shared by 21 NPIs, 797 clinicians

Practice addresses (Care Compare)

733 W Clairemont Ave
Eau Claire, WI 54701-6101
Phone (715) 838-5222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0003944COMDOptometrist
3994WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Aug 21, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Aug 21, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

2321 Stout Rd
Menomonie, WI 54751
Phone (715) 235-5531

Interoperability endpoints

  • Direct secure messaging: bsosalla2248063@ehrdirect.mayoclinicmsg.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1083392088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 W CLAIREMONT",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54701",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11960 Lioness Way Ste 190",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801345640",
            "country_code": "US",
            "telephone_number": "303-794-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOSALLA",
        "first_name": "BROOKE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3994",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0003944",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.