Individual provider Active NPI

Gabriella Grace Stine, OD

  • Optometrist
  • Weston, WI
National Provider Identifier
1518855816
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4081-35 Issued in WI
Practice address
4009 Community Center Dr
Weston, WI 54476-4139
Phone
(715) 241-2020
Fax
(715) 241-9827
NPI assigned
Jun 25, 2025
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 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 4081-35 WI Primary

Addresses

Primary practice location

4009 Community Center Dr
Weston, WI 54476-4139

Mailing address

4009 Community Center Dr
Weston, WI 54476-4139
Phone (715) 241-2020

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
I20250929001514 WI Practitioner - Optometry 1557867645 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthview Eye Care Center, SCGroup PAC ID 5890769368, 5 clinicians
Stine Eye Center, LLCGroup PAC ID 1759357718, 5 clinicians

Practice addresses (Care Compare)

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

4009 Community Ctr Dr
Suite 100
Weston, WI 54476-4139
Phone (715) 241-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stine Eye Center, LLC Optometrist CurrentSince Aug 22, 2025 Accepting new patients
Healthview Eye Care Center-Medford SC Optometrist CurrentSince Oct 15, 2025 Accepting new patients
Healthview Eye Care Centers, SC Optometrist CurrentSince Oct 15, 2025 Accepting new patients

Locations

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

4009 Community Center Dr
Weston, WI 54476
Phone (715) 241-2020

4009 Community Center Dr
#100
Weston, WI 54476
Phone (715) 241-2020

Interoperability endpoints

  • Direct secure messaging: gabriellag.stine@direct.revolutionehr.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1518855816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 COMMUNITY CENTER DR",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764139",
            "telephone_number": "715-241-2020",
            "fax_number": "715-241-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 COMMUNITY CENTER DR",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764139",
            "telephone_number": "715-241-2020",
            "fax_number": "715-241-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINE",
        "first_name": "GABRIELLA",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "4081-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

Verify at the official NPI Registry.