NPIMap

Organization Active NPI

Eye Clinic of Wisconsin, S.C.

  • Ophthalmology Physician
  • Stevens Point, WI
National Provider Identifier
1962485615
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE CLINIC OF WISCONSIN, S.C.
Practice address
3401 Stanley St
Stevens Point, WI 54481-1326
Phone
(715) 344-6544
Fax
(715) 344-7391
NPI assigned
Nov 28, 2005
Last updated
Jul 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Authorized official

Name
Sharon J Long, COE
Title
Administrator
Phone
(715) 261-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X WI Primary

Addresses

Primary practice location

3401 Stanley St
Stevens Point, WI 54481-1326

Mailing address

PO Box 689
Wausau, WI 54402-0689
Phone (715) 261-8500

Other identifiers 1

IdentifierTypeStateIssuer
32667800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040806000745 WI Part B Supplier - Clinic/Group Practice 9436121829 Receives reassigned benefits from 22 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rhinelander, WI; Wisconsin Rapids, WI; Wausau, WI; Stevens Point, WI; Merrill, WI; Medford, WI; Marshfield, WI; Antigo, WI
O20100930002045 WI DME Supplier - Physician - OphthalmologyDME Supplier - Physician - Optometrist 9436121829 Practice locations: Stevens Point, WI

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eye Clinic of Wisconsin SC3401 Stanley St, Stevens Point, WI 54481-1326(715) 344-6544 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Eye Clinic of Wisconsin SC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2 E Ocala St
Rhinelander, WI 54501
Phone (715) 362-2600

800 N 1st St
Wausau, WI 54403
Phone (715) 261-8500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311033600000",
    "number": "1962485615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544020689",
            "telephone_number": "715-261-8500",
            "fax_number": "715-261-8667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 STANLEY ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811326",
            "telephone_number": "715-344-6544",
            "fax_number": "715-344-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CLINIC OF WISCONSIN, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2011-07-19",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "715-261-8500",
        "authorized_official_credential": "COE"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32667800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.