David W Kisiolek, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1742 Issued in WI

Practice address

300 Audubon Rd
Howards Grove, WI 53083-1280

Phone

(920) 565-3991

Fax

(920) 565-4404

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Illinois College of Optometry at Chicago, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

David W Kisiolek OD SCGroup PAC ID 7214934587, 2 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.

• David W. Kisiolek, O.D., S.C.

  • Optometrist
  • Howards Grove, WI
  • NPI 1619065224
  Medicare reassignment Care Compare group NPD Authorized official
• Viktor & Mariya, LLC

  • Optometrist
  • Howards Grove, WI
  • NPI 1427918846
  Medicare reassignment NPD

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1285748459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 AUDUBON RD",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831280",
            "telephone_number": "920-565-3991",
            "fax_number": "920-565-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 AUDUBON RD",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831280",
            "telephone_number": "920-565-3991",
            "fax_number": "920-565-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISIOLEK",
        "first_name": "DAVID",
        "middle_name": "W",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38514400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Noemi Gisell Garcia, D.D.S.
• Howards Grove Family Dental, LLC
• Natalie Jensema
• Aric Jump
• Rebecca Joan Kiekhoefer
• Gloria Jean Koeppen, L.P.N.
• Priyanka Kulkarni, MD
• Makayla Kaytlynn Kulow, DC
• Kelly Kunesh
• Steven Robert Lindstrom, DDS

• Optometrist in Howards Grove, WI
• Providers in Howards Grove, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.