Organization Active NPI

Envision Eyecare LLC

  • Optometrist
  • Wausau, WI
National Provider Identifier
1760454029
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ENVISION EYECARE LLC
Practice address
515 N 17TH Ave
Wausau, WI 54401-2910
Phone
(715) 848-1246
Fax
(715) 842-1660
NPI assigned
Feb 2, 2006
Last updated
Sep 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Authorized official

Name
Jeanine Laffin
Title
Billing and Credentialing
Phone
(715) 848-1246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

515 N 17TH Ave
Wausau, WI 54401-2910

Mailing address

515 N 17TH Ave
Wausau, WI 54401-2910
Phone (715) 848-1246

Other identifiers 2

IdentifierTypeStateIssuer
100238822MedicaidWI
38723800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051130000507 WI Part B Supplier - Clinic/Group Practice 7315967700 Receives reassigned benefits from 3 practitioners
Practice locations: Wausau, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Envision Eyecare LLC515 N 17TH Ave, Wausau, WI 54401-2910(715) 848-1246 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Aug 9, 2005

National Provider Directory

National Provider Directory

Locations

515 N 17th Ave
Wausau, WI 54401
Phone (715) 848-1246

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790294400000",
    "number": "1760454029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N 17TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012910",
            "telephone_number": "715-848-1246",
            "fax_number": "715-842-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N 17TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012910",
            "telephone_number": "715-848-1246",
            "fax_number": "715-842-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A",
        "authorized_official_last_name": "LAFFIN",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_title_or_position": "BILLING AND CREDENTIALING",
        "authorized_official_telephone_number": "715-848-1246"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100238822",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38723800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.