Individual provider Active NPI

Todd M Lenhard, OD

  • Optometrist
  • Green Bay, WI
National Provider Identifier
1568498087
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2662 Issued in WI
Practice address
2292 Main St
Green Bay, WI 54311
Phone
(920) 465-7990
Fax
(920) 465-9634
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2662 WI Primary

Addresses

Primary practice location

2292 Main St
Green Bay, WI 54311

Mailing address

PO Box 22576
Green Bay, WI 54305-2576
Phone (920) 465-7990

Other identifiers 1

IdentifierTypeStateIssuer
38597900MedicaidWI

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
I20091015000338 WI Practitioner - Optometry 0941346308 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lenhard Professional Services LLC CurrentSince Aug 11, 2009 Accepting new patients

Locations

2292 Main St
Green Bay, WI 54311
Phone (920) 465-7737

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1568498087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22576",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052576",
            "telephone_number": "920-465-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2292 MAIN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-465-7990",
            "fax_number": "920-465-9634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENHARD",
        "first_name": "TODD",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38597900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.