Ross Ira Clair, OD
Individual provider Active NPI Optometrist · Caledonia, WI
NPI 1942501770 · NPPES record last updated Feb 28, 2024
Key facts
- NPI
- 1942501770
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 3177035 (WI)
- Practice address
- 5333 Douglas Ave
Caledonia, WI 53402-2032 - Phone
- (262) 752-2100
- NPI assigned
- Nov 10, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- New England College of Optometry, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Medical Group, Inc.
Practice addresses (Care Compare)
5333 Douglas Ave
Racine, WI 53402-2032
Phone (262) 752-2100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221012000830 | WI | Practitioner - Optometry | 5597131839 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3177035 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
5333 Douglas Ave
Caledonia, WI 53402
Phone (262) 752-2100
6815 118th Ave
Kenosha, WI 53142
Phone (262) 857-5600
6815 118th Ave
Ste 204
Kenosha, WI 53142
3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
Interoperability endpoints
- rclair353565@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3177035 | WI | Yes |
Addresses
Primary practice location
5333 Douglas Ave
Caledonia, WI 53402-2032
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
17550 W Bluemound Rd
Brookfield, WI 53045-2928
Phone (262) 784-3700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100215187 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rclair353565@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Caledonia, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.