Active NPI
Katherine Beerntsen, OD
- Optometrist
- Janesville, WI
National Provider Identifier
1114082443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2338
- Practice address
- 2500 Milton Ave
Janesville, WI 53545-0452 - Phone
- (608) 757-2633
- Fax
- (608) 757-2625
- NPI assigned
- Dec 27, 2006
- Last updated
- Apr 3, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2338 | WI | Primary |
Addresses
Primary practice location
2500 Milton Ave
Janesville, WI 53545-0452
Mailing address
1680 Hawkinson Rd
Oregon, WI 53575-2306
Phone (608) 873-9680
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38599500 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2338 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica Retail North America Inc | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients | |
| Stein Optical Inc. | Optometrist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lenscrafters #00029
- Eyewear Supplier
- Milwaukee, WI
- NPI 1265507313
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238716800000",
"number": "1114082443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1680 HAWKINSON RD",
"city": "OREGON",
"state": "WI",
"postal_code": "535752306",
"telephone_number": "608-873-9680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 MILTON AVE",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535450452",
"telephone_number": "608-757-2633",
"fax_number": "608-757-2625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEERNTSEN",
"first_name": "KATHERINE",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2009-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "2338",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38599500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Janesville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.