Eye to Eye Optical

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

EYE TO EYE OPTICAL

Practice address

1659 N Spring St Ste 101B
Beaver Dam, WI 53916-1280

Phone

(920) 885-3318

Fax

(920) 885-3319

NPI assigned

Apr 1, 2011

Last updated

Apr 1, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Patrick Bellotti II, OPTICIAN

Title

Member

Phone

(414) 491-0397

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1083903769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 N SPRING ST STE 101B",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539161280",
            "telephone_number": "920-885-3318",
            "fax_number": "920-885-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1659 N SPRING ST STE 101B",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539161280",
            "telephone_number": "920-885-3318",
            "fax_number": "920-885-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE TO EYE OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "BELLOTTI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "414-491-0397",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD NPI",
            "identifier": "1700951605",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Eyewear Supplier in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.