Brodhead Vision is a medicare enrolled "Optometrist" provider in Brodhead, Wisconsin. Their current practice location is
1005 17th Street, Brodhead, Wisconsin. You can reach out to their office (for appointments etc.) via phone at
(608) 897-2128.
Brodhead Vision is licensed to practice in Wisconsin (license number 1483-035) and it also participates in the medicare program. Brodhead Vision
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1164416236.
Healthcare Provider's Profile
| Full Name | Brodhead Vision |
|---|
| Type | Facility |
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| Speciality | Optometrist |
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| Location | 1005 17th Street, Brodhead, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1164416236
- Provider Enumeration Date: 09/06/2005
- Last Update Date: 10/08/2014
Medicare PECOS Information:
- PECOS PAC ID: 8426021163
- Enrollment ID: O20110113000189
Medical Identifiers
Medical identifiers for Brodhead Vision such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164416236 | NPI | - | NPPES |
| RAILROAD MEDICARE | Other | WI | 410035917 |
| 38545800 | Medicaid | WI | |
| PHYSICIANS PLUS | Other | WI | 1006622 |
| MERCYCARE | Other | WI | PRUDHGEN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 1483-035 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Brodhead Vision acts as a billing entity for following providers:
| Provider Name | Douglas E Kelley |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1033376090
PECOS PAC ID: 2769511385
Enrollment ID: I20100520000129 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brodhead Vision is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Brodhead Vision
1005 17th Street, Po Box 0137,
Brodhead, WI 53520
Ph: (608) 897-2128 | Brodhead Vision
1005 17th Street,
Brodhead, WI 53520
Ph: (608) 897-2128 |
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