Individual provider Active NPI

Kelsey Linn Rickels, O.D.

  • Optometrist
  • Madison, WI
National Provider Identifier
1194988618
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3164-35 Issued in WI
Practice address
780 Regent St Ste 306
Madison, WI 53715-2635
Phone
(608) 257-4286
Fax
(608) 257-1608
NPI assigned
Jul 3, 2008
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3164-35 WI Primary

Addresses

Primary practice location

780 Regent St Ste 306
Madison, WI 53715-2635

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other identifiers 1

IdentifierTypeStateIssuer
046010110MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krickels388975@direct.uwhealth.org

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
I20100226000854 WI Practitioner - Optometry 5092889188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

780 Regent St
Madison, WI 53715-2635
Phone (608) 287-2095

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
3164-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince Dec 21, 2009 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 22, 2018 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 22, 2018 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

780 Regent St
Madison, WI 53715
Phone (608) 257-4286

780 Regent St
Ste 306
Madison, WI 53715
Phone (608) 257-4286

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

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1194988618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 REGENT ST STE 306",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537152635",
            "telephone_number": "608-257-4286",
            "fax_number": "608-257-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKELS",
        "first_name": "KELSEY",
        "middle_name": "LINN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3164-35",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010110",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krickels388975@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "780 Regent St Ste 306",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537152635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.