Cody W Dagnall, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3809 Issued in WI

Practice address

308 W Fulton St # 1422
Waupaca, WI 54981-1422

Phone

(715) 258-8168

NPI assigned

May 3, 2022

Last updated

Sep 6, 2022By the provider in NPPES

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

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Wisconsin Professional LTDGroup PAC ID 1557372968, 16 clinicians

Advanced Family EyecareGroup PAC ID 5890718142, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.73 of 100Reported as group

Quality

99.46

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cody.dagnall@direct.revolutionehr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Family Eyecare

  • Optometrist
  • Waupaca, WI
  • NPI 1578640223
  Medicare reassignment Care Compare group NPD
• Aeg Wisconsin Professional LTD

  dba Christenson Vision Care

  • Optometrist
  • Hudson, WI
  • NPI 1407801087
  Medicare reassignment Care Compare group
• Myeyedr Optometry of Wisconsin, LLC

  dba MyEyeDr.

  • Optometrist
  • Kenosha, WI
  • NPI 1164992996
  Medicare reassignment NPD
• Myeyedr Optometry of Wisconsin, LLC

  dba MyEyeDr.

  • Optometrist
  • West Allis, WI
  • NPI 1710632864
  NPD
• Myeyedr Optometry of Wisconsin, LLC

  dba MyEyeDr.

  • Optometrist
  • Wisconsin Rapids, WI
  • NPI 1801460563
  NPD

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1851036867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 S MAIN ST",
            "city": "FALL RIVER",
            "state": "WI",
            "postal_code": "539329594",
            "telephone_number": "920-296-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 W FULTON ST # 1422",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811422",
            "telephone_number": "715-258-8168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 Parkwood Dr",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "544945488",
            "country_code": "US",
            "telephone_number": "715-421-2111",
            "fax_number": "715-421-2123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAGNALL",
        "first_name": "CODY",
        "middle_name": "W",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Waupaca (Waupaca County Dept of Human Services)
• County of Waupaca (Waupaca County Dept of Human Services)
• Stephanie Jean Crane, LCSW
• Crossroads Care Center of Crystal River LLC
• Crystal River Dental, LLC
• Ismail A Dania, MD
• Daniel L. Gauerkei Dba Broadway Vision Center (Broadway Vision Center)
• Tracy Marie Darnutzer, OTR
• Amanda Debauche, OTR
• Den Services, Inc.

• Optometrist in Waupaca, WI
• Providers in Waupaca, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.