Organization Active NPI

Onalaska Vision Associates, Inc.

  • Optometrist
  • Onalaska, WI
National Provider Identifier
1194956748
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2639 Issued in WI
Legal business name
ONALASKA VISION ASSOCIATES, INC.
Practice address
3107 Market PL
Onalaska, WI 54650-6756
Phone
(608) 781-7150
Fax
(608) 781-7152
NPI assigned
Jul 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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

Authorized official

Name
Dr. Robert RuprechtNPI 1679668867
Title
Optometrist/President
Phone
(608) 781-9129

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2639 WI Primary

Addresses

Primary practice location

3107 Market PL
Onalaska, WI 54650-6756

Mailing address

325 W Larkspur LN
Onalaska, WI 54650-8313
Phone (608) 781-9129

Other identifiers 1

IdentifierTypeStateIssuer
38595300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050502000061 WI Part B Supplier - Clinic/Group Practice 6103865977 Receives reassigned benefits from 1 practitioner
Practice locations: Onalaska, WI

National Provider Directory

National Provider Directory

Locations

3107 Market Pl
Onalaska, WI 54650
Phone (608) 781-7150

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252368000000",
    "number": "1194956748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W LARKSPUR LN",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508313",
            "telephone_number": "608-781-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 MARKET PL",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546506756",
            "telephone_number": "608-781-7150",
            "fax_number": "608-781-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONALASKA VISION ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-09-08",
        "status": "A",
        "authorized_official_last_name": "RUPRECHT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OPTOMETRIST/PRESIDENT",
        "authorized_official_telephone_number": "608-781-9129",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38595300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.