Individual provider Active NPI

Stephen C Sternitzky, O.D.

  • Optometrist
  • Wisconsin Rapids, WI
National Provider Identifier
1790768968
Registry record updated Jun 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2207-035 Issued in WI
Practice address
1220 Parkwood Drive
Wisconsin Rapids, WI 54494-5488
Phone
(715) 421-2111
Fax
(715) 421-2123
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2207-035 WI Primary

Addresses

Primary practice location

1220 Parkwood Drive
Wisconsin Rapids, WI 54494-5488

Mailing address

1220 Parkwood Drive
Wisconsin Rapids, WI 54494-5488
Phone (715) 421-2111

Other identifiers 1

IdentifierTypeStateIssuer
38576000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231102003892 MN Practitioner - Optometry 3971628736 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2207-035WIMDOptometrist
2207WIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince Sep 24, 2023 Accepting new patients
Shoptikal LLC Optometrist CurrentSince Dec 6, 2022 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince Dec 6, 2022 Accepting new patients
Shoptikal LLC Optometrist Past Accepting new patients

Locations

1004 18th Ave NW
Ste D
Austin, MN 55912
Phone (507) 437-8228

2220 Badger Dr
Hudson, WI 54016
Phone (715) 954-6063

101 Oak Ave
Ste 2
Menomonie, WI 54751
Phone (715) 953-3731

6000 Monona Dr
Ste 101
Monona, WI 53716
Phone (608) 222-9420

1100 E Riverview Expy
Wisconsin Rapids, WI 54494
Phone (715) 421-1750

Organizations & group practices 6

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244160000000",
    "number": "1790768968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 PARKWOOD DRIVE",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544945488",
            "telephone_number": "715-421-2111",
            "fax_number": "715-421-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 PARKWOOD DRIVE",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544945488",
            "telephone_number": "715-421-2111",
            "fax_number": "715-421-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERNITZKY",
        "first_name": "STEPHEN",
        "middle_name": "C",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2009-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2207-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38576000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

Verify at the official NPI Registry.