NPIMap

Organization Active NPI

Fuerste Eye Clinic

  • Ophthalmology Physician
  • Dubuque, IA
National Provider Identifier
1255301875
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
FUERSTE EYE CLINIC
Practice address
2140 JFK Rd
Dubuque, IA 52002-3883
Phone
(563) 582-0769
Fax
(563) 582-5772
NPI assigned
Jan 25, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gretchen Fuerste, MDNPI 1811977671
Title
Vice President
Phone
(563) 582-0769

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

2140 JFK Rd
Dubuque, IA 52002-3883

Mailing address

2140 JFK Rd
Dubuque, IA 52002-3883
Phone (563) 582-0769

Other identifiers 1

IdentifierTypeStateIssuer
0201517MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL, WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040309000960 IA Part B Supplier - Clinic/Group Practice 0941198063 Receives reassigned benefits from 7 practitioners
Practice locations: Dubuque, IA
O20140905001334 IL Part B Supplier - Clinic/Group Practice 0941198063 Receives reassigned benefits from 1 practitioner
Practice locations: Galena, IL
O20200128001928 WI Part B Supplier - Clinic/Group Practice 0941198063 Receives reassigned benefits from 2 practitioners
Practice locations: Lancaster, WI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Fuerste Eye Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2140 John F Kennedy Rd
Dubuque, IA 52002
Phone (563) 582-0769

2140 John F Kennedy Rd
Ste F
Dubuque, IA 52002

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255301875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 JFK RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520023883",
            "telephone_number": "563-582-0769",
            "fax_number": "563-582-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 JFK RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520023883",
            "telephone_number": "563-582-0769",
            "fax_number": "563-582-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUERSTE EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FUERSTE",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "563-582-0769",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0201517",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.