Nicholas Joel Komro, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2903-035 Issued in WI

Practice address

520 Wilson Ave
Menomonie, WI 54751-2516

Phone

(715) 235-2855

Fax

(715) 235-9436

NPI assigned

Aug 18, 2005

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

Illinois College of Optometry at Chicago, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Menomonie Eye and Optical LLCGroup PAC ID 7719195247, 2 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.

• Menomonie Eye & Optical LLC

  • Eyewear Supplier
  • Menomonie, WI
  • NPI 1194922690
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1750373585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 WILSON AVE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512516",
            "telephone_number": "715-235-2855",
            "fax_number": "715-235-9436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 WILSON AVE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512516",
            "telephone_number": "715-235-2855",
            "fax_number": "715-235-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMRO",
        "first_name": "NICHOLAS",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2903-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38719700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Know Peace LLC
• Laura L Knudsen, M.S., R.D.N., C.D.
• Rachel Knudson
• Erin M Knutson, NP
• Stephanie M Koepp, O.T.
• Samuel Lawrence Konrath, ATC, LAT
• Joel A Kowski, DPM
• Mary J Kragness, AOTA
• Erin L Kraiss
• William N Kratz, OTR

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.