Active NPI
Dean Fait, OD
- Optometrist
- Marshfield, WI
National Provider Identifier
1780799205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2426
- Practice address
- 107 S Central Ave
Marshfield, WI 54449-2834 - Phone
- (715) 660-8337
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2426 | WI | Primary |
Addresses
Primary practice location
107 S Central Ave
Marshfield, WI 54449-2834
Mailing address
107 S Central Ave
Marshfield, WI 54449-2834
Phone (715) 660-8337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38609000 | Medicaid | WI |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181017002277 | WI | Practitioner - Optometry | 3678604535 | Practice locations: Marshfield, WI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2426 | WI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539302400000",
"number": "1780799205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 S CENTRAL AVE",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544492834",
"telephone_number": "715-660-8337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 S CENTRAL AVE",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544492834",
"telephone_number": "715-660-8337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIT",
"first_name": "DEAN",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2018-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "2426",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38609000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marshfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.