Vita Park Eye Associates, Sc is a medicare enrolled "Ophthalmology" provider in Beaver Dam, Wisconsin. Their current practice location is
240 Corporate Drive, Beaver Dam, Wisconsin. You can reach out to their office (for appointments etc.) via phone at
(920) 887-1151.
Vita Park Eye Associates, Sc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Vita Park Eye Associates, Sc
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 1154418051.
Healthcare Provider's Profile
| Full Name | Vita Park Eye Associates, Sc |
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| Type | Facility |
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| Speciality | Ophthalmology |
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| Location | 240 Corporate Drive, Beaver Dam, 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: 1154418051
- Provider Enumeration Date: 10/10/2006
- Last Update Date: 04/21/2021
Medicare PECOS Information:
- PECOS PAC ID: 8527956754
- Enrollment ID: O20040309000339
Medical Identifiers
Medical identifiers for Vita Park Eye Associates, Sc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154418051 | NPI | - | NPPES |
| CP765 | Other | WI | RAIL ROAD MEDICARE |
| 21310700 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Vita Park Eye Associates, Sc acts as a billing entity for following providers:
| Provider Name | Jay M Wilkins |
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| Provider Type | Practitioner - Ophthalmology |
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| Provider Identifiers | NPI Number: 1932125093
PECOS PAC ID: 6305817701
Enrollment ID: I20040802000070 |
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| Provider Name | Thomas A Castillo |
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| Provider Type | Practitioner - Ophthalmology |
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| Provider Identifiers | NPI Number: 1700805454
PECOS PAC ID: 9739077967
Enrollment ID: I20060316000608 |
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| Provider Name | Charles P Hendrix |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1588747547
PECOS PAC ID: 6103910302
Enrollment ID: I20070919000346 |
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| Provider Name | Cory Alan Springstroh |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1639481534
PECOS PAC ID: 8224221403
Enrollment ID: I20101020000618 |
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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. Vita Park Eye Associates, Sc 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 |
|---|
Vita Park Eye Associates, Sc
240 Corporate Drive,
Beaver Dam, WI 53916
Ph: (920) 887-1151 | Vita Park Eye Associates, Sc
240 Corporate Drive,
Beaver Dam, WI 53916
Ph: (920) 887-1151 |
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