ANNIKA PAULSEN OD
NPI 1164083705
Optometrist in Sturgeon Bay, WI

Active since June 25, 2019PECOS EnrolledAccepts Medicare Assignment
88.84/100
CMS Quality Rating
165 N 3RD AVE, STURGEON BAY, WI 54235(920) 743-2020 Get Directions Write a Review

NPPES record last updated: June 25, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Annika Paulsen Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANNIKA PAULSEN OD (NPI 1164083705) is an individual optometrist in Sturgeon Bay, Wisconsin, licensed in Wisconsin (3570-35) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2019).

NPPES Registry Identity

NPI1164083705
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameANNIKA PAULSENCredential: OD
Location Address165 N 3RD AVESturgeon Bay, WI 54235-2415
Mailing Address165 N 3rd AveSturgeon Bay, WI 54235-2415 · (920) 743-2020
Sole ProprietorNo
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2019
Enumeration DateJune 25, 2019
NPI 1164083705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License Licensed in WI · 3570-35
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
165 N 3RD AVE, Sturgeon Bay, WI 54235

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Annika Paulsen Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3274868195
PECOS Enrollment IDI20190716000485
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
7,269 services48 patients
Removal of recurring cataract in lens capsule using a laser 66821
This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
1,080 services12 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
435 services435 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
206 services136 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
172 services152 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
170 services162 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54235 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

88.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.68
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier18 claims18 services$62.31 avg. paid by Medicare
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens V2303
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier15 claims25 services$54.72 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Optometrist
165 N 3RD AVE
STURGEON BAY, WI 54235
Optometrist
165 N 3RD AVE
STURGEON BAY, WI 54235
Optometrist
165 N 3RD AVE
STURGEON BAY, WI 54235
Optometrist
165 N 3RD AVE
STURGEON BAY, WI 54235

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Annika Paulsen's NPI number?

The NPI number for Annika Paulsen is 1164083705. It was assigned to this individual provider in the NPPES registry on June 25, 2019.

Where is Annika Paulsen located?

Annika Paulsen practices at 165 N 3rd Ave, Sturgeon Bay, WI 54235. The listed phone number is (920) 743-2020.

What is Annika Paulsen's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Annika Paulsen enrolled in Medicare?

Yes. Annika Paulsen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Annika Paulsen accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners, Network Health and UnitedHealthcare list Annika Paulsen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Annika Paulsen was last updated on June 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.