Individual provider Active NPI

Sara Davis Schalk, OD

  • Optometrist
  • Appleton, WI
National Provider Identifier
1275617300
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2975 Issued in WI
Practice address
21 Park PL
Appleton, WI 54914-8872
Phone
(920) 739-4361
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2975 WI Primary

Addresses

Primary practice location

21 Park PL
Appleton, WI 54914-8872

Mailing address

21 Park PL
Appleton, WI 54914-8872
Phone (920) 739-4361

Other identifiers 1

IdentifierTypeStateIssuer
2974OtherWILICENSE

Other names 1

  • Dr. Sara Jean Davis Former name

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
I20041206000732 WI Practitioner - Optometry 3072413855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Eye AssociatesGroup PAC ID 5395633580, 25 clinicians

Practice addresses (Care Compare)

2500 E Capitol Dr
Suite 3500
Appleton, WI 54911-8735
Phone (920) 358-1820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2975WIMDClinical Social Worker
2853MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Eye Associates Optometrist CurrentSince Apr 1, 2012 Accepting new patients
Park Place Optical, LTD Past Accepting new patients
Wyoming Family Vision Care PLLC Optometrist PastSince Nov 1, 2004 Accepting new patients
Luxottica of America Inc Past Accepting new patients
Wyoming Family Vision Care LLC Optometrist Past Accepting new patients

Locations

21 Park Pl
Appleton, WI 54914
Phone (920) 739-4361

2500 E Capitol Dr
Ste 3500
Appleton, WI 54911
Phone (920) 358-1820

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

Interoperability endpoints

  • Direct secure messaging: sschalk34881@direct.thedacare.org

Organizations & group practices 5

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1275617300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PARK PL",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148872",
            "telephone_number": "920-739-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PARK PL",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148872",
            "telephone_number": "920-739-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHALK",
        "first_name": "SARA",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2974",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "DAVIS",
            "middle_name": "JEAN",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.