Individual provider Active NPI

Garth Neil Christenson, O.D.

  • Optometrist
  • Hudson, WI
National Provider Identifier
1346226560
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1992-35 Issued in WI
Practice address
2215 Vine St
Ste E
Hudson, WI 54016-5802
Phone
(715) 381-1234
Fax
(715) 381-5357
NPI assigned
Dec 20, 2005
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1992-35 WI Primary
Pediatric Optometrist 152WP0200X 1992-35 WI

Addresses

Primary practice location

2215 Vine St
Ste E
Hudson, WI 54016-5802

Mailing address

2215 Vine St
Ste E
Hudson, WI 54016-5802
Phone (715) 381-1234

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
I20060530000206 WI Practitioner - Optometry 4183635592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Wisconsin Professional LTDGroup PAC ID 1557372968, 16 clinicians

Practice addresses (Care Compare)

2215 Vine St
Suite E
Hudson, WI 54016-5862
Phone (715) 381-1234

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Wisconsin Professional LTD Optometrist CurrentSince Jul 1, 2006 Accepting new patients

Locations

2215 Vine St
Ste E
Hudson, WI 54016
Phone (715) 381-1234

Organizations & group practices 1

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1346226560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 VINE ST",
            "address_2": "STE E",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540165802",
            "telephone_number": "715-381-1234",
            "fax_number": "715-381-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 VINE ST",
            "address_2": "STE E",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540165802",
            "telephone_number": "715-381-1234",
            "fax_number": "715-381-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSON",
        "first_name": "GARTH",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1992-35",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "WI",
            "license": "1992-35",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.