Individual provider Active NPI

Matthew Theirl, OD

  • Optometrist
  • Amery, WI
National Provider Identifier
1194565408
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3997-35 Issued in WI
Practice address
120 Keller Ave N # 1034
Amery, WI 54001-1034
Phone
(715) 268-9010
NPI assigned
May 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3997-35 WI Primary

Addresses

Primary practice location

120 Keller Ave N # 1034
Amery, WI 54001-1034

Mailing address

120 Keller Ave N # 1034
Amery, WI 54001-1034
Phone (715) 268-9010

Other practice location 1

304 S 1st St
Luck, WI 54853-8017
Phone (715) 472-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251008002241 MN Practitioner - Optometry 4284131947 Reassigns benefits to 1 organization
I20260416003460 WI Practitioner - Optometry 4284131947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sees the Day LTDGroup PAC ID 7517921372, 8 clinicians

Practice addresses (Care Compare)

113 Carmichael Rd
Hudson, WI 54016-7716
Phone (715) 377-7970

7150 Valley Creek PLZ
Suite 216
Woodbury, MN 55125-2271
Phone (651) 738-4886

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3997-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sees the Day LTD Optometrist CurrentSince Jul 24, 2025 Accepting new patients
Sees the Day LTD Optometrist CurrentSince Jul 24, 2025 Accepting new patients
Midwest Mobile Eye LLC Optometrist CurrentSince May 17, 2026 Accepting new patients

Locations

1757 N Frontage Rd
Hastings, MN 55033
Phone (651) 480-8515

7150 Valley Creek Plz
Ste 216
Woodbury, MN 55125
Phone (651) 738-4886

113 Carmichael Rd
Hudson, WI 54016
Phone (715) 377-7970

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1194565408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 KELLER AVE N # 1034",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011034",
            "telephone_number": "715-268-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KELLER AVE N # 1034",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011034",
            "telephone_number": "715-268-9010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 S 1st St",
            "address_purpose": "LOCATION",
            "city": "Luck",
            "state": "WI",
            "postal_code": "548538017",
            "country_code": "US",
            "telephone_number": "715-472-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEIRL",
        "first_name": "MATTHEW",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3997-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amery, WI

Sources for this page

Verify at the official NPI Registry.