Individual provider Active NPI

Casey A Thompson, O.D.

  • Optometrist
  • Waunakee, WI
National Provider Identifier
1578862322
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3291-35 Issued in WI
Practice address
1300 S Century Ave
Waunakee, WI 53597-2386
Phone
(608) 849-4315
Fax
(608) 850-1606
NPI assigned
Mar 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3291-35 WI Primary

Addresses

Primary practice location

1300 S Century Ave
Waunakee, WI 53597-2386

Mailing address

1300 S Century Ave
Waunakee, WI 53597-2386
Phone (608) 849-4315

Other identifiers 1

IdentifierTypeStateIssuer
1578862322MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cthompson264021@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20130926000398 WI Practitioner - Optometry 8325210362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

1300 S Century Ave
Waunakee, WI 53597-2386
Phone (608) 849-4315

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3291-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Sep 12, 2013 Accepting new patients
Dean Health Systems, Inc. CurrentSince Sep 12, 2013 Accepting new patients

Locations

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

1300 S Century Ave
Waunakee, WI 53597
Phone (608) 849-4315

Interoperability endpoints

  • Direct secure messaging: cthompson264021@direct-ehr-ssmhc.com

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, 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": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1578862322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S CENTURY AVE",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "535972386",
            "telephone_number": "608-849-4315",
            "fax_number": "608-850-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S CENTURY AVE",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "535972386",
            "telephone_number": "608-849-4315",
            "fax_number": "608-850-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CASEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-18",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3291-35",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578862322",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cthompson264021@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cthompson264021@direct-ehr-ssmhc.com",
            "address_1": "1300 S Century Ave",
            "city": "Waunakee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535972386",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1300 S Century Ave",
            "city": "Waunakee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535972386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waunakee, WI

Sources for this page

Verify at the official NPI Registry.