Individual provider Active NPI

Nancy Shebuski, OD

  • Optometrist
  • Wausau, WI
National Provider Identifier
1215034046
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1971 Issued in WI
Practice address
2727 Plaza Dr
Wausau, WI 54401-4129
Phone
(715) 847-3000
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1971 WI Primary

Addresses

Primary practice location

2727 Plaza Dr
Wausau, WI 54401-4129

Mailing address

217 S 52ND Ave
Wausau, WI 54401-8068
Phone (715) 393-5894

Other identifiers 1

IdentifierTypeStateIssuer
38530600MedicaidWI

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
I20100615000361 WI Practitioner - Optometry 4284764473 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1971WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Marshfield Clinic Inc CurrentSince Nov 18, 2002 Accepting new patients

Locations

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

2727 Plaza Dr
Wausau, WI 54401
Phone (715) 847-3000

Organizations & group practices 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1215034046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 S 52ND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544018068",
            "telephone_number": "715-393-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 PLAZA DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014129",
            "telephone_number": "715-847-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEBUSKI",
        "first_name": "NANCY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38530600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.