Jeffrey L Vodak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1843 Issued in WI

Practice address

105 East Jefferson Street
Spring Green, WI 53588

Phone

(608) 588-2612

Fax

(608) 588-3227

NPI assigned

Jan 18, 2007

Last updated

Jul 8, 2007By 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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Spring Green Vision Center, Inc.

  • Optometrist
  • Spring Green, WI
  • NPI 1427103084
  Authorized official Same address or phone

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548313265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "SPRING GREEN",
            "state": "WI",
            "postal_code": "535880100",
            "telephone_number": "608-588-2612",
            "fax_number": "608-588-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 EAST JEFFERSON STREET",
            "city": "SPRING GREEN",
            "state": "WI",
            "postal_code": "53588",
            "telephone_number": "608-588-2612",
            "fax_number": "608-588-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VODAK",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark G Timmerman, MD
• Upland Hills Health, Inc (Upland Hills Health Therapy Outreach)
• Upland Hills Health, Inc, (Upland Hills Health Clinic - Spring Green)
• Upland Hills Health, Inc. (Upland Hills Health Clinic - Spring Green)
• Village Family Dental Associates
• Jaclyn M Wilkinson, RD
• Robert John Wright, PT
• Thomas D Yentz, D.D.S.

• Optometrist in Spring Green, WI
• Providers in Spring Green, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.