Individual provider Active NPI

Perry A Arndt, O.D.

  • Optometrist
  • Medford, WI
National Provider Identifier
1497732663
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1421 Issued in WI
Practice address
309 E Broadway Ave
Medford, WI 54451-1835
Phone
(715) 748-2020
Fax
(715) 748-4565
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1421 WI Primary

Addresses

Primary practice location

309 E Broadway Ave
Medford, WI 54451-1835

Mailing address

309 E Broadway Ave
P.O. Box 547
Medford, WI 54451-1835
Phone (715) 748-2020

Other practice location 1

120 Dehne Dr Ste G
Colby, WI 54421-9589
Phone (715) 223-4003

Other identifiers 15

IdentifierTypeStateIssuer
38715100MedicaidWI
39-1229699OtherWIFEDERAL TAX ID - MEDFORD
391967186019OtherWIBLUE CROSS BLUE SHIELD-CO
410031756OtherWIRAILROAD MEDICARE-MEDFORD
1271670001OtherWIDMERC-COLBY GROUP
391229699015OtherWIBLUE CROSS BLUE SHIELD-ME
410045064OtherWIRAILROAD MEDICARE-COLBY
9103OtherWISECURITY HEALTH PLAN-COLB
0474980001OtherWIDMERC-MEDFORD GROUP
3862100MedicaidWI
38715300MedicaidWI
1421OtherWILISCENSE NUMBER
10445OtherWINVA-MEDFORD
750OtherWISECURITY HEALTH PLAN-MEDF
39-1967186OtherWIFEDERAL TAX ID - COLBY

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
I20061117000379 WI Practitioner - Optometry 5496729873 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1421WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healthview Eye Care Center-Medford SC Optometrist CurrentSince Aug 10, 1999 Accepting new patients
Healthview Eye Care Center - Chippewa, SC Optometrist PastSince Oct 1, 2006 Accepting new patients

Locations

120 Dehne Dr
Ste G
Colby, WI 54421
Phone (715) 223-4003

309 E Broadway Ave
Medford, WI 54451
Phone (715) 748-2020

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1497732663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E BROADWAY AVE",
            "address_2": "P.O. BOX 547",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511835",
            "telephone_number": "715-748-2020",
            "fax_number": "715-748-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E BROADWAY AVE",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511835",
            "telephone_number": "715-748-2020",
            "fax_number": "715-748-4565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Dehne Dr Ste G",
            "address_purpose": "LOCATION",
            "city": "Colby",
            "state": "WI",
            "postal_code": "544219589",
            "country_code": "US",
            "telephone_number": "715-223-4003",
            "fax_number": "715-223-4417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARNDT",
        "first_name": "PERRY",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38715100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID - MEDFORD",
            "identifier": "39-1229699",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD-CO",
            "identifier": "391967186019",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-MEDFORD",
            "identifier": "410031756",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC-COLBY GROUP",
            "identifier": "1271670001",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD-ME",
            "identifier": "391229699015",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-COLBY",
            "identifier": "410045064",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH PLAN-COLB",
            "identifier": "9103",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC-MEDFORD GROUP",
            "identifier": "0474980001",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3862100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38715300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSE NUMBER",
            "identifier": "1421",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA-MEDFORD",
            "identifier": "10445",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH PLAN-MEDF",
            "identifier": "750",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID - COLBY",
            "identifier": "39-1967186",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, WI

Sources for this page

Verify at the official NPI Registry.