Individual provider Active NPI

Ryan Edward Beloungy, O.D.

  • Optometrist
  • Chippewa Falls, WI
National Provider Identifier
1396943049
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3081-035 Issued in WI
Practice address
331 E Prairie View Rd
Chippewa Falls, WI 54729-3463
Phone
(715) 726-9077
NPI assigned
Jul 4, 2007
Last updated
Jun 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3081-035 WI Primary

Addresses

Primary practice location

331 E Prairie View Rd
Chippewa Falls, WI 54729-3463

Mailing address

203 E Maple St
Thorp, WI 54771-9224
Phone (608) 358-1932

Other identifiers 1

IdentifierTypeStateIssuer
38632700MedicaidWI

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
I20071203000408 WI Practitioner - Optometry 9739278482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardinal Family Eye Care LLCGroup PAC ID 7012006760, 4 clinicians

Practice addresses (Care Compare)

509 E S Ave
Chippewa Falls, WI 54729-3402
Phone (715) 726-9077

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3081-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cardinal Family Eye Care LLC Optometrist Current Accepting new patients
Cardinal Family Eye Care LLC Optometrist CurrentSince Oct 12, 2007 Accepting new patients

Locations

509 E South Ave
Chippewa Fls, WI 54729
Phone (715) 669-5631

201 E Hill St
Thorp, WI 54771
Phone (715) 669-5631

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, 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": "1183507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1396943049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E MAPLE ST",
            "city": "THORP",
            "state": "WI",
            "postal_code": "547719224",
            "telephone_number": "608-358-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 E PRAIRIE VIEW RD",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547293463",
            "telephone_number": "715-726-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELOUNGY",
        "first_name": "RYAN",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-04",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3081-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38632700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

Verify at the official NPI Registry.