Ken Martell, OD
Individual provider Active NPI Optometrist · Marathon, WI
NPI 1386697613 · NPPES record last updated Sep 19, 2019
Key facts
- NPI
- 1386697613
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2772 (WI)
- Practice address
- 703 3Rd St
Marathon, WI 54448-9157 - Phone
- (715) 443-2248
- Fax
- (715) 443-9969
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
601 S Webb St
Wittenberg, WI 54499-9042
Phone (715) 253-2157
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060620000184 | WI | Practitioner - Optometry | 0749292407 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoptikal LLC | Optometrist | Current |
Accepting new patients |
| Martell Eyecare, LLC | Optometrist | Current |
Accepting new patients |
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
| Shoptikal LLC | Optometrist | Current |
Accepting new patients |
| Raymond M Goga | Optometrist | Past | Accepting new patients |
| Raymond M Goga | Optometrist | Past |
Accepting new patients |
| Shopko Stores Operating Co LLC | Past | Accepting new patients |
Locations
3415 Calumet Ave
#3
Manitowoc, WI 54220
Phone (920) 683-2244
703 3rd St
Marathon, WI 54448
Phone (715) 443-2248
717 S Central Ave
Marshfield, WI 54449
Phone (715) 387-8608
1306 N Central Ave
Marshfield, WI 54449
Phone (715) 387-3705
1306 N Central Ave
#409
Marshfield, WI 54449
6000 Monona Dr
Ste 101
Monona, WI 53716
Phone (608) 222-9420
174 Crossroads Dr
Plover, WI 54467
Phone (715) 342-9634
1045 E Grand Ave
Rothschild, WI 54474
Phone (715) 359-0649
101 N Western Ave
Ste 101
Waupaca, WI 54981
Phone (534) 400-2068
4551 8th St S
Ste 102
Wisconsin Rapids, WI 54494
Phone (715) 423-1340
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2772 | WI | Yes |
Addresses
Primary practice location
703 3Rd St
Marathon, WI 54448-9157
Mailing address
322 Ross Ave
Wausau, WI 54403-6965
Other practice location 1
1306 N Central Ave
Marshfield, WI 54449-1507
Phone (715) 387-8608
Other practice location 2
601 S Webb St
Wittenberg, WI 54499-9042
Phone (715) 253-2157
Other providers in Marathon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.