Kristen K Dorman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2673-035 Issued in WI

Practice address

120 Martin Dr
Fredonia, WI 53021-9455

Phone

(262) 692-9000

Fax

(262) 692-2797

NPI assigned

Apr 27, 2006

Last updated

Mar 12, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Focus Eyecare LLCGroup PAC ID 4981910999, 3 clinicians

Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Schuster Family Eyecare LLCGroup PAC ID 0547699092, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Focus Eyecare LLC

  • Optometrist
  • West Bend, WI
  • NPI 1508242256
  Medicare reassignment Care Compare group NPD
• Schuster Family Eyecare LLC

  • Optometrist
  • Menomonee Falls, WI
  • NPI 1821621210
  Medicare reassignment Care Compare group NPD
• Shoptikal LLC

  dba Shopko Optical 4002

  • Eyewear Supplier
  • Green Bay, WI
  • NPI 1659937159
  Medicare reassignment Care Compare group
• Myeyedr Optometry of Wisconsin, LLC

  dba MyEyeDr.

  • Optometrist
  • Kenosha, WI
  • NPI 1164992996
  Medicare reassignment NPD
• Christensen Eyecare Professionals

  • Point of Service
  • Pewaukee, WI
  • NPI 1972798577
  NPD
• Myeyedr Optometry of Wisconsin, LLC

  dba MyEyeDr.

  • Optometrist
  • New Berlin, WI
  • NPI 1659833218
  NPD
• Myeyedr Optometry of Wisconsin, LLC

  dba MyEyeDr.

  • Optometrist
  • West Allis, WI
  • NPI 1710632864
  NPD
• Medical Eye Associates, S.C.

  • Ophthalmology Physician
  • Waukesha, WI
  • NPI 1023066636
  NPD (past)
• Medical Eye Associates, S.C.

  • Eyewear Supplier
  • Oconomowoc, WI
  • NPI 1972935906
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1609833110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MARTIN DR",
            "city": "FREDONIA",
            "state": "WI",
            "postal_code": "530219455",
            "telephone_number": "262-692-9000",
            "fax_number": "262-692-2797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Delafield St",
            "address_2": "Suite 312",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531883417",
            "country_code": "US",
            "telephone_number": "262-547-3352",
            "fax_number": "262-547-9142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "KRISTEN",
        "middle_name": "K",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2673-035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly A.V. Briggs, M.S., CCC-SLP
• Broadstep-Wisconsin, Inc.
• David L Brouillette, D.C.
• Matthew Francis Byers, OD
• Jenna Conforti
• Dr. David L. Brouillette, D.C., S.C.
• Fredonia Adult Day Center
• Megan Gavin
• Maggie A Graff, CD
• Keri Gregg, RN

• Optometrist in Fredonia, WI
• Providers in Fredonia, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.
• 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.