Individual provider Active NPI

Jeffrey M Sarazen, OD

  • Optometrist
  • Wausau, WI
National Provider Identifier
1932171816
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2203 Issued in WI
Practice address
515 N 17TH Ave
Wausau, WI 54401-2910
Phone
(715) 848-1246
Fax
(715) 842-1660
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2203 WI Primary

Addresses

Primary practice location

515 N 17TH Ave
Wausau, WI 54401-2910

Mailing address

515 N 17TH Ave
Wausau, WI 54401-2910
Phone (715) 848-1246

Other identifiers 1

IdentifierTypeStateIssuer
38578200MedicaidWI

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
I20040805000062 WI Practitioner - Optometry 6204807993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Envision Eyecare, LLCGroup PAC ID 7315967700, 3 clinicians

Practice addresses (Care Compare)

515 N 17TH Ave
Wausau, WI 54401-2910
Phone 7158481246313

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2203WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Eyecare, LLC Optometrist CurrentSince Oct 1, 2005 Accepting new patients

Locations

515 N 17th Ave
Wausau, WI 54401
Phone (715) 848-1246

Organizations & group practices 1

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1932171816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N 17TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012910",
            "telephone_number": "715-848-1246",
            "fax_number": "715-842-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N 17TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012910",
            "telephone_number": "715-848-1246",
            "fax_number": "715-842-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARAZEN",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38578200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.