Active NPI
Tom Al Zurakowski, O.D.
- Optometrist
- Appleton, WI
National Provider Identifier
1679552905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- WI2950-035
- Practice address
- 10 Tri Park Way
Appleton, WI 54914-1658 - Phone
- (920) 831-0070
- NPI assigned
- Jan 13, 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 | WI2950-035 | WI | Primary |
Addresses
Primary practice location
10 Tri Park Way
Appleton, WI 54914-1658
Mailing address
10 Tri Park Way
Appleton, WI 54914-1658
Phone (920) 831-0070
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WI2950-035 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milwaukee Vamc | Current | Accepting new patients |
Locations
10 Tri Park Way
Appleton, WI 54914
Phone (920) 831-7990
Organizations & group practices 1
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.
-
- Department of Veterans Affairs (VA) Pharmacy
- Appleton, WI
- NPI 1669643912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675555200000",
"number": "1679552905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 TRI PARK WAY",
"city": "APPLETON",
"state": "WI",
"postal_code": "549141658",
"telephone_number": "920-831-0070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 TRI PARK WAY",
"city": "APPLETON",
"state": "WI",
"postal_code": "549141658",
"telephone_number": "920-831-0070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZURAKOWSKI",
"first_name": "TOM",
"middle_name": "AL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2023-02-05",
"certification_date": "2023-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "WI2950-035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.