Gundersen Lutheran Eye Clinic - Sparta is a medicare enrolled "Optometrist" provider in Sparta, Wisconsin. Their current practice location is
1111 W Wisconsin St, Sparta, Wisconsin. You can reach out to their office (for appointments etc.) via phone at
(608) 782-7300.
Gundersen Lutheran Eye Clinic - Sparta is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Gundersen Lutheran Eye Clinic - Sparta
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 1578518346.
Healthcare Provider's Profile
Full Name | Gundersen Lutheran Eye Clinic - Sparta |
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Type | Facility |
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Speciality | Optometrist |
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Location | 1111 W Wisconsin St, Sparta, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1578518346
- Provider Enumeration Date: 05/23/2006
- Last Update Date: 08/06/2021
Medicare PECOS Information:
- PECOS PAC ID: 9638082779
- Enrollment ID: O20100930025508
Medical Identifiers
Medical identifiers for Gundersen Lutheran Eye Clinic - Sparta such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1578518346 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
152W00000X | Optometrist | (* (Not Available)) | Primary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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. Gundersen Lutheran Eye Clinic - Sparta 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 |
Gundersen Lutheran Eye Clinic - Sparta 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 | Gundersen Lutheran Eye Clinic - Sparta 1111 W Wisconsin St, Sparta, WI 54656 Ph: (608) 782-7300 |
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