Leif E Erickson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1306-035 Issued in WI

Practice address

15601 Railroad St
Suite 301
Hayward, WI 54843-6527

Phone

(715) 634-8616

NPI assigned

Oct 13, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Hayward Family Eye Care, Inc

  • Optometrist
  • Hayward, WI
  • NPI 1053769547
  NPD (past)
• Optom-Eyes Care LLC

  dba Hayward Family Eye Care

  • Optometrist
  • Hayward, WI
  • NPI 1003484601
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1427148485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15601 RAILROAD ST",
            "address_2": "SUITE 301",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548436527",
            "telephone_number": "715-634-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15601 RAILROAD ST",
            "address_2": "SUITE 301",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548436527",
            "telephone_number": "715-634-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "LEIF",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1306-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA & PROVANTAGE",
            "identifier": "11727",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "22-00507",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH",
            "identifier": "22704",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26011R",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87217",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH RISK",
            "identifier": "38568600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "46988",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATRIUM",
            "identifier": "4U216ER",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1001441",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38568600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "38568600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT CARE & CBSA",
            "identifier": "39-1131290",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI CARE",
            "identifier": "87213",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Thomas Duffy, D.D.S,
• Heidi Diane Dumas, NP-C
• Sarah Dums, RN, CNP
• Sabrina Ann Dunlap, MD
• Katherine Matthews Eichten, MD
• Katelyn Ewer
• Laura Lee Fafara, ATC
• Joann Carol Falk, APNP
• Allison Farley, PHARMD
• Tori Feckner, COTA/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.