Individual provider Active NPI

Robert D Ruprecht

  • Optometrist
  • Onalaska, WI
National Provider Identifier
1679668867
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2639 Issued in WI
Practice address
3107 Market Place
Onalaska, WI 54650
Phone
(608) 781-9129
NPI assigned
Oct 4, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2639 WI Primary

Addresses

Primary practice location

3107 Market Place
Onalaska, WI 54650

Mailing address

325 W. Larkspur Lane
Onalaska, WI 54650

Other identifiers 1

IdentifierTypeStateIssuer
38595300MedicaidWI

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
I20050503000024 WI Practitioner - Optometry 4284673054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3107 Market PL
Onalaska, WI 54650-6756
Phone (608) 781-7150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2639WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Onalaska Vision Associates, Inc. Optometrist CurrentSince Sep 2, 2009 Accepting new patients

Locations

3107 Market Pl
Onalaska, WI 54650
Phone (608) 781-7150

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, 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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679668867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W. LARKSPUR LANE",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "54650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 MARKET PLACE",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "54650",
            "telephone_number": "608-781-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPRECHT",
        "first_name": "ROBERT",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38595300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

Verify at the official NPI Registry.