Zhaleh Barari, OD
Individual provider Active NPI Optometrist · Jackson, WI
NPI 1699752907 · NPPES record last updated Nov 27, 2024
Key facts
- NPI
- 1699752907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2864-035 (WI)
- Practice address
- W194 N 16747 Eagle Dr.
Suite N
Jackson, WI 53037 - Phone
- (262) 677-4313
- Fax
- (262) 677-4396
- NPI assigned
- Dec 28, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Ferris State College - College of Optometry, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
W194N16747 Eagle Dr
Suite N
Jackson, WI 53037-9710
Phone (262) 677-4313
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- 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 |
|---|---|---|---|---|
| I20040408000617 | WI | Practitioner - Optometry | 4688667165 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2864 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Vision Center, LLC | Optometrist | Current |
Accepting new patients |
Locations
W194N16747 Eagle Dr
Jackson, WI 53037
W194N16747 Eagle Dr
Ste N
Jackson, WI 53037
Phone (262) 677-4313
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2864-035 | WI | Yes |
Addresses
Primary practice location
W194 N 16747 Eagle Dr.
Suite N
Jackson, WI 53037
Mailing address
W194 N 16747 Eagle Dr.
Suite N
Jackson, WI 53037
Phone (262) 677-4313
Other providers in Jackson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2024. 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.