Nicholas George Hafeman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2770 - 035 Issued in WI

Practice address

4301 W Wisconsin Ave
Appleton, WI 54913-8605

Phone

(920) 730-8770

NPI assigned

Jan 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shoptikal LLC

  • Eyewear Supplier
  • Green Bay, WI
  • NPI 1659937159

  Optometrist

  Medicare reassignment Care Compare group NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Beloit, WI
  • NPI 1700442175

  Optometrist

  NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Rockford, IL
  • NPI 1467311142

  Optometrist

  NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Fond Du Lac, WI
  • NPI 1205492675

  Optometrist

  NPD (past)
• Shoptikal LLC

  • Eyewear Supplier
  • Waupaca, WI
  • NPI 1437727856

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114074416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W WISCONSIN AVE",
            "address_2": "FOX RIVER MALL",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138605",
            "telephone_number": "920-757-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W WISCONSIN AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138605",
            "telephone_number": "920-730-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFEMAN",
        "first_name": "NICHOLAS",
        "middle_name": "GEORGE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2770 - 035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill M Haase, PA-C
• Richard A Hack, DDS
• Brooke Hackel, LPC-IT
• Dennis Haen, L.A.T.
• Jennifer Haen, NP
• Jonathan E Hagen, MD
• Kimeko Jean Hagen, B.S, SAC-IT
• Kelly J Hagerty, LCSW
• Whitney L Hagglund, APNP
• Theresa Ann Hagman, PTA

• Optometrist in Appleton, WI
• Providers in Appleton, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.