Active NPI
Farzana Akter
- Optometrist
- Waupun, WI
National Provider Identifier
1346821725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3832-35
- Practice address
- 608 W Brown St
Waupun, WI 53963-1788 - Phone
- (920) 324-8030
- Fax
- (920) 324-8031
- NPI assigned
- Apr 18, 2021
- Last updated
- Mar 3, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 009314 | NY | |
| Optometrist | 152W00000X | 3832-35 | WI | Primary |
Addresses
Primary practice location
608 W Brown St
Waupun, WI 53963-1788
Mailing address
608 W Brown St
Waupun, WI 53963-1788
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- State University of New York - State College Optometry, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
608 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-6800
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3832-35 | WI | MD | Optometrist |
| 009314 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agnesian Healthcare, Inc | Single Specialty | Current | Accepting new patients |
| Agnesian Healthcare Inc | Current | Accepting new patients | |
| Agnesian Healthcare Inc | Optometrist | Current | Accepting new patients |
Locations
1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497
360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111
608 W Brown St
Waupun, WI 53963
Phone (920) 324-6800
Interoperability endpoints
- fakter442483@direct-ehr-ssmhc.com
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.
-
dba SSM Health St Agnes Hospital Fond Du Lac
- General Acute Care Hospital
- Fond Du Lac, WI
- NPI 1346228541
Single Specialty
-
dba SSM Health Fond Du Lac Regional Clinic
- Family Medicine Physician
- Fond Du Lac, WI
- NPI 1730162991
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677801600000",
"number": "1346821725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 W BROWN ST",
"city": "WAUPUN",
"state": "WI",
"postal_code": "539631788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 W BROWN ST",
"city": "WAUPUN",
"state": "WI",
"postal_code": "539631788",
"telephone_number": "920-324-8030",
"fax_number": "920-324-8031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AKTER",
"first_name": "FARZANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-18",
"last_updated": "2023-03-03",
"certification_date": "2023-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "009314",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "3832-35",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waupun, WI
- Agnesian Healthcare (Fond Du Lac Regional Clinic)
- Agnesian Healthcare Enterprises LLC (Agnesian Pharmacy Waupun)
- Agnesian Healthcare Inc (SSM Health Pharmacy)
- Agnesian Healthcare Inc (SSM Health Fond Du Lac Regional Clinic)
- Agnesian Healthcare Inc (Fond du Lac Regional Clinic)
- Bryce Jordan Aul, MD
- Michelle Paul Bahn-Palma, D.O.
- Charles G Baynton, MD
- Beaver Dam Community Hospitals Inc (Marshfield Medical Center - Beaver Dam Waupun Eye Clinic)
- Beaver Dam Community Hospitals Inc ((Inactive) Marshfield Medical Center - Beaver Dam Waupun Center (HOPD)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.