Individual provider Active NPI

Bokaye M. Dietmeier, OD

  • Optometrist
  • Madison, WI
National Provider Identifier
1467897611
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3294-035 Issued in WI
Practice address
425 W Washington Ave Ste 100
Madison, WI 53703-2738
Phone
(608) 256-4750
Fax
(608) 255-7464
NPI assigned
May 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3294-035 WI Primary

Addresses

Primary practice location

425 W Washington Ave Ste 100
Madison, WI 53703-2738

Mailing address

425 W Washington Ave Ste 100
Madison, WI 53703-2738
Phone (608) 256-4750

Other practice location 1

7601 University Ave Ste 102
Middleton, WI 53562-5413
Phone (608) 831-3366

Other practice location 2

6012 Gemini Dr
Madison, WI 53718-3008
Phone (608) 249-5548

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
I20130731000295 WI Practitioner - Optometry 7214178409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Isthmus Eye Care SCGroup PAC ID 9032011002, 8 clinicians

Practice addresses (Care Compare)

6012 Gemini Dr
Madison, WI 53718-3008
Phone (608) 249-5548

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3294-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of South Alabama Health Care Authority PastSince Sep 1, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1467897611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W WASHINGTON AVE STE 100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032738",
            "telephone_number": "608-256-4750",
            "fax_number": "608-255-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W WASHINGTON AVE STE 100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032738",
            "telephone_number": "608-256-4750",
            "fax_number": "608-255-7464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7601 University Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Middleton",
            "state": "WI",
            "postal_code": "535625413",
            "country_code": "US",
            "telephone_number": "608-831-3366",
            "fax_number": "608-831-8470",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6012 Gemini Dr",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537183008",
            "country_code": "US",
            "telephone_number": "608-249-5548",
            "fax_number": "609-249-9090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIETMEIER",
        "first_name": "BOKAYE",
        "middle_name": "M.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3294-035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.