Community Eyecare Inc is a medicare enrolled "Optometrist" provider in Brillion, Wisconsin. Their current practice location is
950 W Ryan St, Suite A, Brillion, Wisconsin. You can reach out to their office (for appointments etc.) via phone at
(920) 756-2020.
Community Eyecare Inc is licensed to practice in Wisconsin (license number 2676) and it also participates in the medicare program. Community Eyecare Inc
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 1548457757.
Healthcare Provider's Profile
| Full Name | Community Eyecare Inc |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 950 W Ryan St, Brillion, 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: 1548457757
- Provider Enumeration Date: 10/02/2007
- Last Update Date: 05/15/2008
Medicare PECOS Information:
- PECOS PAC ID: 5092770743
- Enrollment ID: O20041123000016
Medical Identifiers
Medical identifiers for Community Eyecare Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1548457757 | NPI | - | NPPES |
| 38601700 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 2676 (Wisconsin) | Primary |
| 152W00000X | Optometrist | 2869 (Wisconsin) | Secondary |
| 152WC0802X | Optometrist - Corneal And Contact Management | 2676 (Wisconsin) | Secondary |
| 152WC0802X | Optometrist - Corneal And Contact Management | 2869 (Wisconsin) | Secondary |
| 152WL0500X | Optometrist - Low Vision Rehabilitation | 2676 (Wisconsin) | Secondary |
| 152WP0200X | Optometrist - Pediatrics | 2676 (Wisconsin) | Secondary |
| 152WP0200X | Optometrist - Pediatrics | 2869 (Wisconsin) | Secondary |
| 152WS0006X | Optometrist - Sports Vision | 2676 (Wisconsin) | Secondary |
| 152WS0006X | Optometrist - Sports Vision | 2869 (Wisconsin) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Community Eyecare Inc acts as a billing entity for following providers:
| Provider Name | Charles J Burgess |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1699768333
PECOS PAC ID: 7810952561
Enrollment ID: I20041202000983 |
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| Provider Name | Micah James Juedes |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1851708572
PECOS PAC ID: 5991921744
Enrollment ID: I20140731000211 |
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| Provider Name | Jonathan G Menos |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1932580537
PECOS PAC ID: 9931411931
Enrollment ID: I20150706000735 |
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| Provider Name | Nathan Michael Larson |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1073207445
PECOS PAC ID: 8022479815
Enrollment ID: I20230726001475 |
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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. Community Eyecare Inc 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 |
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Community Eyecare Inc
1255 Appleton Rd, Po Box 534,
Menasha, WI 54952-1501
Ph: (920) 722-6872 | Community Eyecare Inc
950 W Ryan St, Suite A,
Brillion, WI 54110
Ph: (920) 756-2020 |
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