Andrew Congdon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3346-35 Issued in WI

Practice address

3003 Cleveland Ave
A
Marinette, WI 54143-3760

Phone

(920) 883-0632

NPI assigned

Jun 17, 2014

Last updated

Sep 21, 2023By 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

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrewcongdon@direct.revolutionehr.com

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.

• Congdon Optometry Inc

  • Optician
  • Marinette, WI
  • NPI 1003932088

  Optometrist

  Medicare reassignment NPD

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1467866509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 CLEVELAND AVE",
            "address_2": "A",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541433760",
            "telephone_number": "715-732-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 CLEVELAND AVE",
            "address_2": "A",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541433760",
            "telephone_number": "920-883-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONGDON",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3346-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Christian, RN
• Cynthia Churm, MSW LCSW
• Brian Cleven, ATC, LAT, RCEP
• Communication Cabin Inc.
• Congdon Optometry Inc
• Kevin Congdon, O. D.
• Nicole Ann Conklin, PHARMD
• Julie R Conley, PHYSICAL THERAPIST
• Mitchell C Connell, LPC
• Lisa R Cook, NP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.