Individual provider Active NPI

Andrew C Lavey, OD

  • Optometrist
  • Sheboygan, WI
National Provider Identifier
1710953609
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2707035 Issued in WI
Practice address
1442 N 31St St
Sheboygan, WI 53081-3061
Phone
(920) 452-5400
Fax
(920) 452-1920
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2707035 WI Primary

Addresses

Primary practice location

1442 N 31St St
Sheboygan, WI 53081-3061

Mailing address

1442 N 31St St
Sheboygan, WI 53081-3061
Phone (920) 452-5400

Other identifiers 1

IdentifierTypeStateIssuer
30254400MedicaidWI

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
I20050304000524 WI Practitioner - Optometry 8123072980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Larson Eye Care SCGroup PAC ID 8022098409, 4 clinicians

Practice addresses (Care Compare)

1442 N 31St St
Sheboygan, WI 53081-3061
Phone (920) 452-5400

Merit-based Incentive Payment System (MIPS)

Final score
69.37 of 100Reported as group
Quality
66.85
Promoting interoperability
50
Improvement activities
40
Cost
72.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2707035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Larson Eye Care SC CurrentSince Sep 14, 1998 Accepting new patients

Locations

1442 N 31st St
Sheboygan, WI 53081
Phone (920) 452-1810

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1710953609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 N 31ST ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813061",
            "telephone_number": "920-452-5400",
            "fax_number": "920-452-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1442 N 31ST ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813061",
            "telephone_number": "920-452-5400",
            "fax_number": "920-452-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVEY",
        "first_name": "ANDREW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2707035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30254400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.