Stephen J Pruett

Primary specialty

OptometristTaxonomy code 152W00000X

License

1963-035 Issued in WI

Practice address

3805B Spring St
Suite 140
Racine, WI 53405-1641

Phone

(262) 637-8835

Fax

(262) 635-8027

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eye Centers of Racine and Kenosha LTD

  • Ophthalmology Physician
  • Mt Pleasant, WI
  • NPI 1710905781

  Optometrist

  Medicare reassignment NPD
• Eye Centers of Racine and Kenosha LTD

  • Ophthalmology Physician
  • Mount Pleasant, WI
  • NPI 1558232926
  NPD

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1427070259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805B SPRING ST",
            "address_2": "SUITE 140",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051641",
            "telephone_number": "262-637-8835",
            "fax_number": "262-635-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805B SPRING ST",
            "address_2": "SUITE 140",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051641",
            "telephone_number": "262-637-8835",
            "fax_number": "262-635-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1963-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38583200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priceless Time Adult Family Home, LLC
• Dolores Diane Prince, HYGIENIST
• Betty Jean Pringle-Burkhalter, P.T.
• Professional Services Group, Inc.
• Debra Kaye Prudhom III, RN
• Jacqueline Pruitt
• Jean Marie Pruscha, CSAC, ICS
• Ilona Agata Pryomski, NP
• Psychological & Counseling Services Inc
• Krystle Rose Pulda

• Optometrist in Racine, WI
• Providers in Racine, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.