Nicholas J Keszo, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2947-035 Issued in WI

Practice address

W3275 Wolf River Road
Keshena, WI 54135

Phone

(715) 799-3361

Fax

(715) 799-3099

NPI assigned

Jun 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Menominee Indian Tribe of WisconsinGroup PAC ID 2668459264, 24 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Menominee Indian Tribe of Wisconsin

  • Family Medicine Physician
  • Keshena, WI
  • NPI 1568404721
  Medicare reassignment Care Compare group NPD
• Foster Primary Eye Care

  • Optometrist
  • Black River Falls, WI
  • NPI 1558426130
  NPD (past)
• Foster Primary Eye Care LTD

  • Optometrist
  • Black River Falls, WI
  • NPI 1972741353
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1710928916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "541350970",
            "telephone_number": "715-799-3361",
            "fax_number": "715-799-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3275 WOLF RIVER ROAD",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "54135",
            "telephone_number": "715-799-3361",
            "fax_number": "715-799-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESZO",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2947-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38620700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Marie Kakwitch, MA, LPC IT
• Tina Kaquatosh
• Peter C. Keenan, M.D.
• Tammy Keller, RDH
• Connie Kessen, RDH
• Rachel B Kielblock, MS, LPC, NCC
• Isabella Krizan
• Scott Krueger, RD
• Jodi L Lindroth, PT
• Jean Lund, RDH

• Optometrist in Keshena, WI
• Providers in Keshena, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.