Pranaya Bista

Primary specialty

OptometristTaxonomy code 152W00000X

License

3694-35 Issued in WI

Practice address

10996 N Port Washington Rd
Mequon, WI 53092-5031

Phone

(262) 240-9870

NPI assigned

Aug 2, 2021

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

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 NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Delavan, WI
  • NPI 1134785520

  Optometrist

  NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Rockford, IL
  • NPI 1467311142

  Optometrist

  NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Hales Corners, WI
  • NPI 1023691797

  Optometrist

  NPD (past)
• Shoptikal LLC

  • Eyewear Supplier
  • Waukesha, WI
  • NPI 1548826951

  Optometrist

  NPD (past)
• Shoptikal LLC

  • Eyewear Supplier
  • Hartford, WI
  • NPI 1912598830

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1124792411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13660 W WILDFLOWER LN",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531517556",
            "telephone_number": "414-241-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10996 N PORT WASHINGTON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925031",
            "telephone_number": "262-240-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISTA",
        "first_name": "PRANAYA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3694-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priti Bhatnagar, RPH
• Nicole L Bickham, PH.D.
• Bireley Family Cares, Inc.
• Teresa Birmingham, DPT
• Dawnmarie Bischel, OT
• Grace Bittman
• Jan M Blanchard, RPH
• Robert W. Blazich, MSW
• Sean Joseph Blazier, LAT, ATC, USAT
• Roberta L. Bloch, M.S.CCC/SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.

Verify at the official NPI Registry.