Active NPI
Tristan Robert Begotka, O.D.
- Optometrist
- Grafton, WI
National Provider Identifier
1114369063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3309-35
- Practice address
- 1210 12TH Ave
Grafton, WI 53024-1924 - Phone
- (262) 377-6800
- Fax
- (262) 377-7287
- NPI assigned
- Jul 19, 2013
- Last updated
- Jul 19, 2013
- Sex
- Male
- 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 | 3309-35 | WI | Primary |
Addresses
Primary practice location
1210 12TH Ave
Grafton, WI 53024-1924
Mailing address
1210 12TH Ave
Grafton, WI 53024-1924
Phone (262) 377-6800
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3309-35 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visionworks, Inc. | Optometrist | Current | Accepting new patients |
| Visionworks, Inc | Current | Accepting new patients | |
| Regner Family Vision Clinic, S.C. | Past | Accepting new patients |
Locations
16025 W Bluemound Rd
Brookfield, WI 53005
Phone (262) 785-0490
4800 Golf Rd
Ste 436
Eau Claire, WI 54701
Phone (715) 834-8404
2500 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 453-2315
Organizations & group practices 4
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.
-
- Durable Medical Equipment & Medical Supplies
- Kenosha, WI
- NPI 1871655787
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374192000000",
"number": "1114369063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 12TH AVE",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530241924",
"telephone_number": "262-377-6800",
"fax_number": "262-377-7287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 12TH AVE",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530241924",
"telephone_number": "262-377-6800",
"fax_number": "262-377-7287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEGOTKA",
"first_name": "TRISTAN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-19",
"last_updated": "2013-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "3309-35",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grafton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.