NPIMap

Individual provider Active NPI

Douglas T. Edwards, M.D.

  • Ophthalmology Physician
  • Wausau, WI
National Provider Identifier
1679556484
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
45495 Issued in WI
Practice address
800 N 1St St
Wausau, WI 54403-4754
Phone
(715) 261-8500
Fax
(715) 261-8671
NPI assigned
Nov 25, 2005
Last updated
Oct 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 45495 WI Primary

Addresses

Primary practice location

800 N 1St St
Wausau, WI 54403-4754

Mailing address

800 N 1St St
Wausau, WI 54403-4754
Phone (715) 261-8500

Other identifiers 2

IdentifierTypeStateIssuer
34386000MedicaidWI
002739155OtherWIMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dtedwards@directaddress.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080401000607 WI Practitioner - Ophthalmology 4486698032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Iowa, RJ & L Carver College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Clinic of Wisconsin, S.C.Group PAC ID 9436121829, 22 clinicians

Practice addresses (Care Compare)

800 N 1St St
Wausau, WI 54403-4754
Phone (715) 261-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
96.34
Promoting interoperability
100
Improvement activities
40
Cost
78.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45495WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Clinic of Wisconsin, SC Ophthalmology CurrentSince Feb 21, 2008 Accepting new patients
Eye Clinic of Wisconsin SC Ophthalmology Current Accepting new patients
Eye Clinic of Wisconsin, S.C. Ophthalmology Past Accepting new patients

Locations

101 S Gibson St
#16
Medford, WI 54451
Phone (715) 748-5775

2 E Ocala St
Rhinelander, WI 54501
Phone (715) 362-2600

800 N 1st St
Wausau, WI 54403
Phone (715) 261-8500

Interoperability endpoints

  • Direct secure messaging: dedwards@eyeclinicwi.intellechartdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1679556484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N 1ST ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544034754",
            "telephone_number": "715-261-8500",
            "fax_number": "715-261-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N 1ST ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544034754",
            "telephone_number": "715-261-8500",
            "fax_number": "715-261-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DOUGLAS",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "45495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34386000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "002739155",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dtedwards@directaddress.net",
            "affiliation": "N",
            "address_1": "800 N 1st St",
            "city": "Wausau",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544034754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.