Charles Douglas Stine, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1909035 Issued in WI

Practice address

4009 Community Center Dr
Weston, WI 54476-4139

Phone

(715) 241-2020

Fax

(715) 241-9827

NPI assigned

Dec 28, 2005

Sex

Male

Sole proprietor

Yes

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

Pacific University - College of Optometry, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stine Eye Center, LLCGroup PAC ID 1759357718, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stine Eye Center, LLC

  • Optometrist
  • Weston, WI
  • NPI 1043383755
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1740267129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 COMMUNITY CENTER DR",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764139",
            "telephone_number": "715-241-2020",
            "fax_number": "715-241-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 COMMUNITY CENTER DR",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764139",
            "telephone_number": "715-241-2020",
            "fax_number": "715-241-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINE",
        "first_name": "CHARLES",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1909035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38521100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Stark, OTR
• Trisha Stefonek, PSYD
• Hilary Steltenpohl, MD
• Jennifer Stieber
• Stine Eye Center, LLC
• Gabriella Grace Stine, OD
• Melissa R Stoffel, DO
• Kali L. Storm, PA
• Gina Strasser, CAPSW , SAC-IT
• Danica R Strehlow, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.