Individual provider Active NPI

Ricky L. Scalcucci, O.D

  • Optometrist
  • Wausau, WI
National Provider Identifier
1285617019
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2204 Issued in WI
Practice address
800 1St St
Wausau, WI 54403-4754
Phone
(715) 261-8500
Fax
(715) 261-8665
NPI assigned
Nov 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2204 WI Primary

Addresses

Primary practice location

800 1St St
Wausau, WI 54403-4754

Mailing address

800 1St St
Wausau, WI 54403-4754
Phone (715) 261-8500

Other identifiers 1

IdentifierTypeStateIssuer
38576100MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rscalcucci@directaddress.net

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
I20100604000871 WI Practitioner - Optometry 5496885238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Clinic of Wisconsin, S.C.Group PAC ID 9436121829, 22 clinicians

Practice addresses (Care Compare)

800 N 1St St
Wausau, WI 54403-4754
Phone (715) 261-8500

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
96.34
Promoting interoperability
100
Improvement activities
40
Cost
78.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2204WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Clinic of Wisconsin, S.C. CurrentSince Sep 2, 1997 Accepting new patients
Eye Clinic of Wisconsin, SC CurrentSince Sep 2, 1997 Accepting new patients
Eye Clinic of Wisconsin SC Current Accepting new patients
Eye Clinic of Wisconsin, S.C. Past Accepting new patients

Locations

1207 O Day St
Merrill, WI 54452
Phone (715) 536-2535

503 S Center Ave
Ste 7
Merrill, WI 54452

2 E Ocala St
Rhinelander, WI 54501
Phone (715) 362-2600

800 N 1st St
Wausau, WI 54403
Phone (715) 261-8500

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1285617019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 1ST ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544034754",
            "telephone_number": "715-261-8500",
            "fax_number": "715-261-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 1ST ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544034754",
            "telephone_number": "715-261-8500",
            "fax_number": "715-261-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCALCUCCI",
        "first_name": "RICKY",
        "middle_name": "L.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38576100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rscalcucci@directaddress.net",
            "affiliation": "N",
            "address_1": "800 1st St",
            "city": "Wausau",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544034754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.