Individual provider Active NPI

Herbert Tucker Webb III, O.D.

  • Optometrist
  • Janesville, WI
National Provider Identifier
1306830856
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2646 Issued in WI
Practice address
1205 Suffolk Dr
Janesville, WI 53546-1606
Phone
(608) 754-3379
Fax
(608) 741-1506
NPI assigned
Sep 9, 2005
Last updated
Apr 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2646 WI Primary

Addresses

Primary practice location

1205 Suffolk Dr
Janesville, WI 53546-1606

Mailing address

1205 Suffolk Dr
Janesville, WI 53546-1606
Phone (608) 754-3379

Other identifiers 1

IdentifierTypeStateIssuer
38596300MedicaidWI

Other names 1

  • Dr. H. Tucker Webb III Other 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
I20050121000017 WI Practitioner - Optometry 3971591173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1205 Suffolk Dr
Janesville, WI 53546-1606
Phone (608) 754-3379

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2646WIMDNeonatal/Pediatric Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Elliott & Webb, S.C. Optometrist CurrentSince Apr 1, 2001 Accepting new patients
Anderson & Shapiro Eye Surgeons, SC Past Accepting new patients

Locations

1205 Suffolk Dr
Janesville, WI 53546
Phone (608) 752-1080

Organizations & group practices 3

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1306830856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 SUFFOLK DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535461606",
            "telephone_number": "608-754-3379",
            "fax_number": "608-741-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 SUFFOLK DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535461606",
            "telephone_number": "608-754-3379",
            "fax_number": "608-741-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "HERBERT",
        "middle_name": "TUCKER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38596300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "H.",
            "last_name": "WEBB",
            "middle_name": "TUCKER",
            "prefix": "DR.",
            "suffix": "III",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.