Individual provider Active NPI

Theresa L. Frith, O.D.

  • Optometrist
  • Baraboo, WI
National Provider Identifier
1366497877
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2809-035 Issued in WI
Practice address
1626 Tuttle St
Baraboo, WI 53913-1501
Phone
(608) 356-2020
Fax
(608) 355-7055
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2809-035 WI Primary

Addresses

Primary practice location

1626 Tuttle St
Baraboo, WI 53913-1501

Mailing address

1626 Tuttle St Ste 1
Baraboo, WI 53913-1501
Phone (608) 356-2020

Other identifiers 1

IdentifierTypeStateIssuer
1366497877MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tfrith258548@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20161110001656 WI Practitioner - Optometry 6204981632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

1626 Tuttle St
Baraboo, WI 53913-1501
Phone (608) 355-2033

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2809WIMDGeneral Practice Dentistry
2809-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc. CurrentSince Nov 7, 2016 Accepting new patients
Dean Health Systems, Inc CurrentSince Nov 7, 2016 Accepting new patients

Locations

1626 Tuttle St
Ste 1
Baraboo, WI 53913
Phone (608) 356-2020

1626 Tuttle St
Baraboo, WI 53913
Phone (608) 355-2033

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

2825 Hunters Trl
Portage, WI 53901
Phone (608) 742-5522

Interoperability endpoints

  • Direct secure messaging: tfrith258548@direct-ehr-ssmhc.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1366497877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 TUTTLE ST STE 1",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131501",
            "telephone_number": "608-356-2020",
            "fax_number": "608-355-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 TUTTLE ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131501",
            "telephone_number": "608-356-2020",
            "fax_number": "608-355-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRITH",
        "first_name": "THERESA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2809-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366497877",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfrith258548@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tfrith258548@direct-ehr-ssmhc.com",
            "address_1": "1626 Tuttle St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539131501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1626 Tuttle St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539131501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

Verify at the official NPI Registry.