Individual provider Active NPI

Cory A Springstroh, OD

  • Optometrist
  • Beaver Dam, WI
National Provider Identifier
1639481534
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3183-35 Issued in WI
Practice address
240 Corporate Drive
Beaver Dam, WI 53916-3115
Phone
(920) 887-1151
Fax
(920) 887-3353
NPI assigned
Jul 8, 2010
Last updated
Jan 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3183-35 WI Primary

Addresses

Primary practice location

240 Corporate Drive
Beaver Dam, WI 53916-3115

Mailing address

240 Corporate Drive
Beaver Dam, WI 53916-3115
Phone (920) 887-1151

Other identifiers 1

IdentifierTypeStateIssuer
3183-35OtherWISTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

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
I20101020000618 WI Practitioner - Optometry 8224221403 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

140 Gateway Dr
Waupun, WI 53963-2276
Phone (920) 324-3191

Merit-based Incentive Payment System (MIPS)

Final score
78.6 of 100Reported as group
Quality
56.02
Promoting interoperability
100
Improvement activities
40
Cost
72.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3183-35WIMDOptometrist
3183WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc CurrentSince Sep 28, 2022 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince May 1, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Sep 28, 2022 Accepting new patients
Marshfield Clinic Inc CurrentSince Sep 28, 2022 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince May 1, 2022 Accepting new patients
Beaver Dam Community Hospitals Inc Past Accepting new patients

Locations

240 Corporate Dr
Beaver Dam, WI 53916
Phone (920) 324-3191

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

140 Gateway Dr
Waupun, WI 53963
Phone (715) 324-3191

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 7

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1639481534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 CORPORATE DRIVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163115",
            "telephone_number": "920-887-1151",
            "fax_number": "920-887-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 CORPORATE DRIVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163115",
            "telephone_number": "920-887-1151",
            "fax_number": "920-887-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRINGSTROH",
        "first_name": "CORY",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-08",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3183-35",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3183-35",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "240 Corporate Drive",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

Verify at the official NPI Registry.