Brett Michael Buckley, O.D
Individual provider Active NPI Optometrist · Eau Claire, WI
NPI 1659634848 · NPPES record last updated Mar 8, 2021
Key facts
- NPI
- 1659634848
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 3273-35 (WI)
- Practice address
- 4800 Golf Rd Ste 127
Eau Claire, WI 54701-9049 - Phone
- (715) 834-8404
- NPI assigned
- Jun 21, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 10
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Winona Health Services
Practice addresses (Care Compare)
855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-3650
Hospital & facility affiliations
- Winona Health Services
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI, MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160608000205 | WI | Practitioner - Optometry | 6901196724 | Reassigns benefits to 1 organization |
| I20200115002603 | MN | Practitioner - Optometry | 6901196724 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3549 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visionworks, Inc. | Optometrist | Current |
Accepting new patients |
| Visionworks, Inc. | Optometrist | Current |
Accepting new patients |
| Winona Health Services | Current |
Accepting new patients | |
| Visionworks, Inc | Current |
Accepting new patients | |
| Winona Health Services | Past | Accepting new patients |
Locations
1178 Burnsville Ctr
#2036
Burnsville, MN 55306
Phone (952) 435-5011
640 Apache Mall
Rochester, MN 55902
Phone (507) 252-1540
855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680
16025 W Bluemound Rd
Brookfield, WI 53005
Phone (262) 785-0490
4800 Golf Rd
Ste 127
Eau Claire, WI 54701
Phone (715) 834-8404
4800 Golf Rd
Ste 436
Eau Claire, WI 54701
Phone (715) 834-8404
3800 State Road 16
La Crosse, WI 54601
Phone (608) 781-2020
2500 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 453-2315
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3549 | MN | |
| Optometrist | 152W00000X | 3273-35 | WI | Yes |
Addresses
Primary practice location
4800 Golf Rd Ste 127
Eau Claire, WI 54701-9049
Mailing address
1816 Fenwick Ave
Eau Claire, WI 54701-4418
Phone (715) 579-0576
Other practice location 1
640 Apache Mall
Rochester, MN 55902-2109
Phone (507) 252-1540
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020677066 | Other | WI | VISIONWORKS |
Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.