Active NPI
Jerald E Cundiff, MD
- Ophthalmology Physician
- Sterling, IL
National Provider Identifier
1629068135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 38957
- Practice address
- 101 E Miller Rd
Sterling, IL 61081 - Phone
- (815) 625-4790
- NPI assigned
- Oct 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 38957 | WI | Primary |
Addresses
Primary practice location
101 E Miller Rd
Sterling, IL 61081
Mailing address
800 West Ave S
La Crosse, WI 54601-8806
Phone (608) 791-9871
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 291023300 | Medicaid | MN | |
| 32545800 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Loyola University of Chicago, Stritch School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-3650
Hospital & facility affiliations
- Winona Health Services
- Gundersen Lutheran Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 87 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38957 | WI | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Winona Health Services | Current | Accepting new patients | |
| Winona Health Services | Past | Accepting new patients |
Locations
825 Mankato Ave
Winona, MN 55987
Phone (507) 454-4925
855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Winona, MN
- NPI 1295789352
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Winona, MN
- NPI 1447334602
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- La Crosse, WI
- NPI 1376593442
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Onalaska, WI
- NPI 1871837567
Hospital
-
- General Acute Care Hospital
- Winona, MN
- NPI 1295789352
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531958400000",
"number": "1629068135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 WEST AVE S",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546018806",
"telephone_number": "608-791-9871",
"fax_number": "608-791-7852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E MILLER RD",
"city": "STERLING",
"state": "IL",
"postal_code": "61081",
"telephone_number": "815-625-4790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNDIFF",
"first_name": "JERALD",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-26",
"last_updated": "2018-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "WI",
"license": "38957",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "291023300",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32545800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sterling, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.