Carmen M Alfonso-Kneiert, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2485-035 Issued in WI

Practice address

740 Reena Ave
Suite B
Fort Atkinson, WI 53538-3145

Phone

(920) 563-8468

Fax

(920) 563-0178

NPI assigned

May 15, 2006

Last updated

Oct 27, 2020By the provider in NPPES

Sex

Female

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

Electronic endpoints 2

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

Indiana University - School of Optometry, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: calfonsokneiert258857@direct-ehr-ssmhc.com

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.

• Dean Health Systems, Inc

  dba SSM Health Dean Medical Group

  • Allergy & Immunology Physician
  • Madison, WI
  • NPI 1053358846
  Medicare reassignment Care Compare group NPD
• Dean Health Systems, Inc.

  dba SSM Health Davis Duehr Dean Eye Care - Portage

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
  • NPI 1427085679
  NPD

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1710938634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 REENA AVE",
            "address_2": "SUITE B",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535383145",
            "telephone_number": "920-563-8468",
            "fax_number": "920-563-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 REENA AVE",
            "address_2": "SUITE B",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535383145",
            "telephone_number": "920-563-8468",
            "fax_number": "920-563-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFONSO-KNEIERT",
        "first_name": "CARMEN",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2485-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710938634",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "calfonsokneiert258857@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "calfonsokneiert258857@direct-ehr-ssmhc.com",
            "address_1": "740 Reena Ave",
            "address_2": "Suite B",
            "city": "Fort Atkinson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535383145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "740 Reena Ave",
            "address_2": "Suite B",
            "city": "Fort Atkinson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535383145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Advanced Pain Management SC
• Aegis Group Practice LLC
• Nancy L Aguirre, M.D.
• Alden at Fort Healthcare, LLC
• Laurie A. Alex, RN
• Mary Elizabeth Allie, LPN
• Emma Allison, SLP
• Ailleen R. Alquinto Anonuevo, M.D.
• Alternative Vision Services
• Michael R Anderson, M.D.

• Optometrist in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.