Individual provider Active NPI

David P Sutton, M.D.

  • Ophthalmology Physician
  • Chippewa Falls, WI
National Provider Identifier
1508826918
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
29034-20 Issued in WI
Practice address
2525 County Highway I
Chippewa Falls, WI 54729-1422
Phone
(715) 723-9375
Fax
(715) 723-1092
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35147 AZ
Ophthalmology Physician 207W00000X 036120295 IL
Ophthalmology Physician 207W00000X 29034-20 WI Primary

Addresses

Primary practice location

2525 County Highway I
Chippewa Falls, WI 54729-1422

Mailing address

2525 County Highway I
Chippewa Falls, WI 54729-1422
Phone (715) 723-9375

Other practice location 1

102 S. Hennepin Ave
KSB Medical Group
Dixon, IL 61021-3013
Phone (815) 288-7711

Other practice location 2

101 W 2nd St
Dixon, IL 61021
Phone (815) 285-8523

Other identifiers 2

IdentifierTypeStateIssuer
F400374739OtherILMEDICARE
036120295MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dsutton257253@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.88 of 100Reported as group
Quality
94.46
Improvement activities
40
Cost
73.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35147AZMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KSB Medical Group, Inc. Ophthalmology Past Accepting new patients

Organizations & group practices 1

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1508826918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 COUNTY HIGHWAY I",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547291422",
            "telephone_number": "715-723-9375",
            "fax_number": "715-723-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 COUNTY HIGHWAY I",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547291422",
            "telephone_number": "715-723-9375",
            "fax_number": "715-723-1092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 S. Hennepin Ave",
            "address_2": "KSB Medical Group",
            "address_purpose": "LOCATION",
            "city": "Dixon",
            "state": "IL",
            "postal_code": "610213013",
            "country_code": "US",
            "telephone_number": "815-288-7711",
            "fax_number": "815-285-8901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Dixon",
            "state": "IL",
            "postal_code": "61021",
            "country_code": "US",
            "telephone_number": "815-285-8523",
            "fax_number": "815-285-8901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "DAVID",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "35147",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036120295",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "29034-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "F400374739",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036120295",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsutton257253@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2525 County Highway I",
            "city": "Chippewa Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547291422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.