Organization Active NPI

Dr. Ronald J. Piffl, Optometrist, LLC

  • Optometrist
  • Merrill, WI
National Provider Identifier
1114220225
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2560 Issued in WI
Legal business name
DR. RONALD J. PIFFL, OPTOMETRIST, LLC
Practice address
1007 E 1St St
Merrill, WI 54452-2511
Phone
(715) 536-3250
Fax
(715) 536-2020
NPI assigned
Dec 10, 2010
Last updated
Feb 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

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

Authorized official

Name
Kathryn PifflNPI 1699621912
Title
Office Manager
Phone
(715) 536-3250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2560 WI Primary

Addresses

Primary practice location

1007 E 1St St
Merrill, WI 54452-2511

Mailing address

1007 E 1St St
Merrill, WI 54452-2511

Other identifiers 1

IdentifierTypeStateIssuer
38589400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110127000427 WI Part B Supplier - Clinic/Group Practice 1850570565 Practice locations: Merrill, WI

National Provider Directory

National Provider Directory

Locations

1007 E 1st St
Merrill, WI 54452
Phone (715) 536-3250

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1114220225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 E 1ST ST",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544522511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 E 1ST ST",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544522511",
            "telephone_number": "715-536-3250",
            "fax_number": "715-536-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RONALD J. PIFFL, OPTOMETRIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "PIFFL",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "715-536-3250"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38589400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrill, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.