Individual provider Active NPI

Linda Marie Dejmek, OD

  • Optometrist
  • Appleton, WI
National Provider Identifier
1144286451
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1576 Issued in WI
Practice address
509 S Chain Dr
Appleton, WI 54915-1437
Phone
(920) 733-3629
Fax
(920) 731-8089
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1576 WI Primary

Addresses

Primary practice location

509 S Chain Dr
Appleton, WI 54915-1437

Mailing address

509 S Chain Dr
Appleton, WI 54915-1437
Phone (920) 733-3629

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041006000486 WI Practitioner - Optometry 7618936782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insight Eye Care, LLCGroup PAC ID 1850487489, 4 clinicians

Practice addresses (Care Compare)

1401 McMahon Rd
Suite 100
Neenah, WI 54956-6305
Phone (920) 722-2020

509 Chain Dr
Appleton, WI 54915-1437
Phone (920) 733-3629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1576WIMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Eye Care, LLC Optometrist CurrentSince Feb 8, 2019 Accepting new patients
Insight Eye Care, LLC Optometrist Current Accepting new patients
A B See Vision Therapy Centers SC CurrentSince May 1, 2004 Accepting new patients

Locations

509 Chain Dr
Appleton, WI 54915
Phone (920) 235-5530

1466 Kenwood Dr
Menasha, WI 54952
Phone (920) 722-2020

1401 McMahon Rd
Ste 100
Neenah, WI 54956
Phone (920) 722-2020

251 N Sawyer St
Oshkosh, WI 54902
Phone (920) 235-5530

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1144286451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 S CHAIN DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151437",
            "telephone_number": "920-733-3629",
            "fax_number": "920-731-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 S CHAIN DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151437",
            "telephone_number": "920-733-3629",
            "fax_number": "920-731-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJMEK",
        "first_name": "LINDA",
        "middle_name": "MARIE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.