Desiree Monik Herron, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3168-035 Issued in WI

Practice address

1640 S Church St
Watertown, WI 53094-6406

Phone

(920) 390-2971

Fax

(920) 390-2974

NPI assigned

Nov 23, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Desiree Monik Kaebisch Former name

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

Specialty

Optometry

Education

New England College of Optometry, 2009

Medicare assignment

May accept Medicare assignment

Group practices

Watertown Vision LLCGroup PAC ID 8123267325, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Watertown Vision, LLC

  • Optometrist
  • Watertown, WI
  • NPI 1780935957
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1245568682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 S CHURCH ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946406",
            "telephone_number": "920-390-2971",
            "fax_number": "920-390-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 S CHURCH ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946406",
            "telephone_number": "920-390-2971",
            "fax_number": "920-390-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "DESIREE",
        "middle_name": "MONIK",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-23",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3168-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "476900006",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESIREE",
            "last_name": "KAEBISCH",
            "middle_name": "MONIK",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melanie Terese Heese, RN
• Robert Delano Heinen, MD
• Amber Rose Hendriksen, NP
• Heritage Assisted Living of Watertown, LLC
• Shandell Lee Herrick, FNP-BC
• Gwen Herzog, RN
• Catherine Hetzel
• Angela Hill, OTR
• Nicholas Earl Hoening, PT
• Richard C Holden, M.D.

• Optometrist in Watertown, WI
• Providers in Watertown, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.