Individual provider Active NPI

Kristopher T. Knous, OD

  • Optometrist
  • Sheboygan, WI
National Provider Identifier
1356432199
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2999 Issued in WI
Practice address
1414 N Taylor Dr
Suite 105
Sheboygan, WI 53081-1988
Phone
(920) 208-7700
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2999 WI Primary

Addresses

Primary practice location

1414 N Taylor Dr
Suite 105
Sheboygan, WI 53081-1988

Mailing address

935 N Grant St
Port Washington, WI 53074-1459
Phone (262) 352-7932

Other identifiers 1

IdentifierTypeStateIssuer
38625000MedicaidWI

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
I20041214000667 WI Practitioner - Optometry 9335036664 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PRN Eye Associates LLCGroup PAC ID 8729250261, 3 clinicians

Practice addresses (Care Compare)

950 Port Washington Rd
Grafton, WI 53024-9201
Phone (262) 204-1063

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Mart Inc Optometrist CurrentSince Oct 1, 2009 Accepting new patients
PRN Eye Associates LLC Optometrist CurrentSince Jul 22, 2010 Accepting new patients
Vision Mart, Inc CurrentSince Oct 1, 2009 Accepting new patients

Locations

13685 W Capitol Dr
Brookfield, WI 53005
Phone (262) 790-0088

950 Port Washington Rd
Grafton, WI 53024
Phone (262) 204-1059

12000 W Carmen Ave
Milwaukee, WI 53225
Phone (414) 462-1300

2110 E Oklahoma Ave
Milwaukee, WI 53207
Phone (414) 747-9977

2923 N 15th St
Sheboygan, WI 53083
Phone (920) 452-3900

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1356432199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 N GRANT ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530741459",
            "telephone_number": "262-352-7932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 N TAYLOR DR",
            "address_2": "SUITE 105",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811988",
            "telephone_number": "920-208-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOUS",
        "first_name": "KRISTOPHER",
        "middle_name": "T.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38625000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.