Active NPI
Thomas Wayne Ritzenthaler, OD
- Optometrist
- Baraboo, WI
National Provider Identifier
1962555409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1695
- Practice address
- 222 4TH Ave
Baraboo, WI 53913-2135 - Phone
- (608) 356-3972
- Fax
- (608) 356-6447
- NPI assigned
- Jan 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1695 | WI | Primary |
Addresses
Primary practice location
222 4TH Ave
Baraboo, WI 53913-2135
Mailing address
222 4TH Ave
Baraboo, WI 53913-2135
Phone (608) 356-3972
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38509800 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962555409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 4TH AVE",
"city": "BARABOO",
"state": "WI",
"postal_code": "539132135",
"telephone_number": "608-356-3972",
"fax_number": "608-356-6447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 4TH AVE",
"city": "BARABOO",
"state": "WI",
"postal_code": "539132135",
"telephone_number": "608-356-3972",
"fax_number": "608-356-6447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RITZENTHALER",
"first_name": "THOMAS",
"middle_name": "WAYNE",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "1695",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38509800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baraboo, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.