Individual provider Active NPI

Emily J Parker, O.D.

  • Optometrist
  • Baraboo, WI
National Provider Identifier
1104089911
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3141-35 Issued in WI
Practice address
1626 Tuttle St
Suite 1
Baraboo, WI 53913
Phone
(608) 356-2020
Fax
(608) 356-6787
NPI assigned
Jul 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3141-35 WI Primary

Addresses

Primary practice location

1626 Tuttle St
Suite 1
Baraboo, WI 53913

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other practice location 1

2880 University Ave
Madison, WI 53705-3644
Phone (608) 263-7171

Other identifiers 1

IdentifierTypeStateIssuer
1104089911MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address eparker260915@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20090921000623 WI Practitioner - Optometry 5698849081 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Wisconsin Medical Foundation IncGroup PAC ID 6608785464, 2,537 clinicians

Practice addresses (Care Compare)

2880 University Ave
Madison, WI 53705-3644
Phone (608) 263-9339

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3141WIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jan 8, 2024 Accepting new patients
Dean Health Systems, Inc CurrentSince Jan 1, 2015 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Jan 8, 2024 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jan 1, 2015 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

1626 Tuttle St
Ste 1
Baraboo, WI 53913
Phone (608) 356-2020

1700 Tuttle St
Baraboo, WI 53913
Phone (608) 355-3800

1626 Tuttle St
Baraboo, WI 53913
Phone (608) 355-2033

703 14th St
Baraboo, WI 53913
Phone (608) 355-3800

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

8800 US Highway 61
Lancaster, WI 53813
Phone (608) 723-2113

2880 University Ave
Madison, WI 53705
Phone (608) 263-6421

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

1040 Division St
Mauston, WI 53948
Phone (608) 847-5000

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

2825 Hunters Trl
Portage, WI 53901
Phone (608) 742-5522

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

100 N Main St
Richland Ctr, WI 53581
Phone (608) 647-8995

128 N Tratt St
Whitewater, WI 53190
Phone (262) 473-4514

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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1104089911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 TUTTLE ST",
            "address_2": "SUITE 1",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "53913",
            "telephone_number": "608-356-2020",
            "fax_number": "608-356-6787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2880 University Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537053644",
            "country_code": "US",
            "telephone_number": "608-263-7171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "EMILY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3141-35",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104089911",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eparker260915@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "eparker260915@direct-ehr-ssmhc.com",
            "address_1": "1626 Tuttle St",
            "address_2": "Suite 1",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53913",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1626 Tuttle St",
            "address_2": "Suite 1",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

Verify at the official NPI Registry.