Logan Kiekhafer, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3374-35 Issued in WI

Practice address

1400 Bellinger St
Eau Claire, WI 54703

Phone

(715) 838-5222

NPI assigned

Jun 17, 2015

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

Electronic endpoints 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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, shared by 21 NPIs, 797 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lkiekhafer245859@ehrdirect.mayoclinicmsg.org

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.

• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Menomonie, WI
  • NPI 1154372944
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • Eau Claire, WI
  • NPI 1235588831
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Rural Health Clinic/Center
  • Mondovi, WI
  • NPI 1174116669
  NPD

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1790166536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BELLINGER ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54703",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5530 N Port Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "WI",
            "postal_code": "532174920",
            "country_code": "US",
            "telephone_number": "414-897-0152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5530 N Port Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "WI",
            "postal_code": "532174920",
            "country_code": "US",
            "telephone_number": "414-897-0152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIEKHAFER",
        "first_name": "LOGAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3374-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkiekhafer245859@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1400 Bellinger St",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brenda Kibola, MD
• Ashley Kidd
• Anton I Kidess, MD
• Andrew Kieffer, MD
• Sara Jane Kieffer
• Christopher Kilen, DO
• Hee Woong Kim, M.D.
• Sae Byok Kim, BSW
• Daniel T Kincaid, MD
• Arden Cedar Kindred, LM, CPM

• Optometrist in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.