Individual provider Active NPI

David Gary James, O.D.

  • Optometrist
  • Oregon, WI
National Provider Identifier
1780667204
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1673-035 Issued in WI
Practice address
185 W Netherwood Rd
Oregon, WI 53575-1100
Phone
(608) 835-3579
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1673-035 WI Primary

Addresses

Primary practice location

185 W Netherwood Rd
Oregon, WI 53575-1100

Mailing address

17727 W Dreamview CT
Brooklyn, WI 53521-9662
Phone (608) 455-1005

Other identifiers 1

IdentifierTypeStateIssuer
38508900MedicaidWI

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
I20110114001088 WI Practitioner - Optometry 7810905023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bright Side Eye Care, S.C.Group PAC ID 6002824216, 5 clinicians

Practice addresses (Care Compare)

185 W Netherwood St
Oregon, WI 53575-1100
Phone (608) 835-3579

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1673-035WIMDOptometrist
1673WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Side Eye Care, S.C. Optometrist CurrentSince Apr 1, 1997 Accepting new patients
Bright Side Eye Care, S.C. Optometrist CurrentSince Jan 1, 1980 Accepting new patients

Locations

1532 W Broadway
Ste 103
Monona, WI 53713
Phone (608) 223-0202

185 W Netherwood St
Oregon, WI 53575
Phone (608) 835-3579

Interoperability endpoints

  • Direct secure messaging: anna.rogers@direct.revolutionehr.com

Organizations & group practices 2

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1780667204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17727 W DREAMVIEW CT",
            "city": "BROOKLYN",
            "state": "WI",
            "postal_code": "535219662",
            "telephone_number": "608-455-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 W NETHERWOOD RD",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535751100",
            "telephone_number": "608-835-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "DAVID",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1673-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38508900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, WI

Sources for this page

Verify at the official NPI Registry.