Individual provider Active NPI

Connor Haugen, OD

  • Optometrist
  • Ames, IA
National Provider Identifier
1417529793
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
113176 Issued in IA
Practice address
2020 Philadelphia St
Ames, IA 50010-8772
Phone
(515) 232-2450
Fax
(515) 232-3532
NPI assigned
Jul 15, 2021
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 006998 OH
Optometrist 152W00000X 113176 IA Primary

Addresses

Primary practice location

2020 Philadelphia St
Ames, IA 50010-8772

Mailing address

309 E Church St
Marshalltown, IA 50158-2946
Phone (641) 754-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20220614002881 IA Practitioner - Optometry 8820477300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wolfe Clinic IncGroup PAC ID 8628979291, 37 clinicians

Practice addresses (Care Compare)

2020 Philadelphia St
Ames, IA 50010-8772
Phone (515) 232-2450

309 E Church St
Marshalltown, IA 50158-2946
Phone (641) 754-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006998OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wolfe Clinic Inc Corneal and Contact Management CurrentSince Aug 1, 2022 Accepting new patients

Locations

2020 Philadelphia St
Ames, IA 50010
Phone (515) 232-2450

309 E Church St
Marshalltown, IA 50158
Phone (515) 754-6200

Interoperability endpoints

  • Direct secure messaging: chaugen@wolfe.intellechartdirect.net

Organizations & group practices 1

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": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1417529793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E CHURCH ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501582946",
            "telephone_number": "641-754-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PHILADELPHIA ST",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500108772",
            "telephone_number": "515-232-2450",
            "fax_number": "515-232-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "CONNOR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-15",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "006998",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "113176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

Verify at the official NPI Registry.