Active NPI
William Dick, OD
- Optometrist
- West Bend, WI
National Provider Identifier
1649335662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1345-035
- Practice address
- 1437 S Main St
West Bend, WI 53095-4931 - Phone
- (262) 334-1925
- Fax
- (262) 334-4303
- NPI assigned
- Dec 27, 2006
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1345-035 | WI | Primary |
Addresses
Primary practice location
1437 S Main St
West Bend, WI 53095-4931
Mailing address
11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone (210) 524-6663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38500700 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1345-035 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica Retail North America Inc | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients | |
| Vision Mart, Inc | Past | Accepting new patients | |
| Stein Optical Inc. | Optometrist | Past | Accepting new patients |
| Vision Mart Inc | Optometrist | Past | Accepting new patients |
Organizations & group practices 5
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.
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- Optometrist
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- NPI 1801829551
-
- Optician
- Milwaukee, WI
- NPI 1184753352
-
- Eyewear Supplier
- Kansas City, MO
- NPI 1497412522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1649335662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11103 WEST AVE",
"address_2": "SUITE 6",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782131370",
"telephone_number": "210-524-6663",
"fax_number": "210-524-6587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1437 S MAIN ST",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530954931",
"telephone_number": "262-334-1925",
"fax_number": "262-334-4303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICK",
"first_name": "WILLIAM",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "1345-035",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38500700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.