Individual provider Active NPI

Robert J. Mertz, O.D.

  • Optometrist
  • Fitchburg, WI
National Provider Identifier
1174693246
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2157 Issued in WI
Practice address
3051 Cahill Main
Fitchburg, WI 53711-7109
Phone
(608) 661-7200
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2157 WI Primary

Addresses

Primary practice location

3051 Cahill Main
Fitchburg, WI 53711-7109

Mailing address

1265 John Q Hammons Dr
Madison, WI 53717-1921
Phone (608) 251-4156

Other identifiers 1

IdentifierTypeStateIssuer
38530200MedicaidWI

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
I20040719001337 WI Practitioner - Optometry 8820077175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.21 of 100Reported as group
Quality
71.09
Promoting interoperability
99
Improvement activities
40
Cost
70.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince Apr 7, 2010 Accepting new patients
Suson Eye Specialists, MD SC Past Accepting new patients
Suson Optical Corporation Past Accepting new patients

Locations

3051 Cahill Main
Fitchburg, WI 53711
Phone (608) 257-9700

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

1265 John Q Hammons Dr
Madison, WI 53717

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1174693246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 JOHN Q HAMMONS DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171921",
            "telephone_number": "608-251-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 CAHILL MAIN",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537117109",
            "telephone_number": "608-661-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTZ",
        "first_name": "ROBERT",
        "middle_name": "J.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38530200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

Verify at the official NPI Registry.