Organization Active NPI

Pinnacle Cataract and Laser Institute LLC

  • Ambulatory Surgical Clinic/Center
  • Appleton, WI
National Provider Identifier
1275513806
Registry record updated Oct 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PINNACLE CATARACT AND LASER INSTITUTE LLC
Practice address
4648 W Spencer St
Appleton, WI 54914-9106
Phone
(920) 731-7557
Fax
(920) 731-7558
NPI assigned
Jan 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2010

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

Authorized official

Name
Dr. Michael P Vrabec, M.D.
Title
Co-Executive Director
Phone
(920) 731-7557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

4648 W Spencer St
Appleton, WI 54914-9106

Mailing address

4648 W Spencer St
Appleton, WI 54914-9106
Phone (920) 731-7557

Other identifiers 1

IdentifierTypeStateIssuer
41914200MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050428000330 WI Part B Supplier - Ambulatory Surgical Center 9234178351 Practice locations: Appleton, WI

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Pinnacle Cataract and Laser Institute LLCCCN 52C0001058
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D1054611Pinnacle Cataract & Laser Institute4648 W Spencer St, Appleton, WI 54914Certificate of waiverMay 24, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286755200000",
    "number": "1275513806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4648 W SPENCER ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549149106",
            "telephone_number": "920-731-7557",
            "fax_number": "920-731-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4648 W SPENCER ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549149106",
            "telephone_number": "920-731-7557",
            "fax_number": "920-731-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE CATARACT AND LASER INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2010-10-11",
        "status": "A",
        "authorized_official_last_name": "VRABEC",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CO-EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "920-731-7557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41914200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.