OCONOMOWOC VISION CLINIC, LLC
NPI 1376724377
Optometrist in Oconomowoc, WI

NPI Status: Active since November 18, 2007

Contact Information

1674 OLD SCHOOLHOUSE RD
SUITE 101
OCONOMOWOC, WI
ZIP 53066
Phone: (262) 567-2295
Fax: (262) 567-0744

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  • Organization
  • Optometrist
  • Accepts Insurance
  • Medicare Supplier
  • Accepts Medicare Approved Payment

About OCONOMOWOC VISION CLINIC, LLC

This page provides the complete NPI Profile along with additional information for Oconomowoc Vision Clinic, Llc, a provider established in Oconomowoc, Wisconsin operating as a Optometrist. The healthcare provider is registered in the NPI registry with number 1376724377 assigned on November 2007. The practitioner's primary taxonomy code is 152W00000X with license number 3017 (WI). The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is David Mark Bjork O.d. (Owner/optometrist)

NPI
1376724377
Provider Name
OCONOMOWOC VISION CLINIC, LLC
Entity Type
Organization
Location Address
1674 OLD SCHOOLHOUSE RD SUITE 101 OCONOMOWOC, WI 53066
Location Phone
(262) 567-2295
Location Fax
(262) 567-0744
Mailing Address
1674 OLD SCHOOLHOUSE RD SUITE 101 OCONOMOWOC, WI 53066
Mailing Phone
(262) 567-2295
Mailing Fax
(262) 567-0744
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-18-2007
Last Update Date
05-10-2013
Code Navigator



Oconomowoc Vision Clinic, Llc is a medicare supplier with PTAN 26715754 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Conventional Contact Lenses.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Optometrist

Taxonomy Code
152W00000X
Type
Eye and Vision Services Providers
License No.
3017
License State
WI
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible - PPO
  • Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits - PPO
  • Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits - PPO
  • Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible - PPO
  • Blue Max Copay (PCP) 60/40 $6000 Standardized - PPO
  • Blue Max Copay (PCP) 75/55 $2000 Standardized - PPO
  • Blue Saver 60/40 $6100 - PPO
  • Blue Saver 90/70 $3400 - PPO
  • BlueSelect Bronze Basic - PPO
  • BlueSelect Bronze Core - PPO
  • BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
  • BlueSelect Gold Core - PPO
  • BlueSelect Gold HealthPlus - PPO
  • BlueSelect Gold Standard without Kid's Dental - PPO
  • BlueSelect Silver Classic - PPO
  • BlueSelect Silver Classic without Kid's Dental - PPO
  • BlueSelect Silver HealthPlus - PPO
  • BlueSelect Silver HealthPlus without Kid's Dental - PPO
  • BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • Enrich $2,000 - 25% - HMO
  • Enrich $3,500 - 30% - HMO
  • Enrich $4,000 - 50% - HMO
  • Enrich $5,000 HDHP - HMO
  • Enrich $6,000 - 40% - HMO
  • Enrich $7,500 - HMO
  • Enrich $7,500 HDHP - HMO
  • Enrich $9,500 - HMO
  • Enrich Protection - HMO
  • Premier $2,000 - 25% - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DAVID MARK BJORK O.D.

Authorized Official Title
OWNER/OPTOMETRIST
Authorized Official Phone
(262) 567-2295

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
6160440001MEDICARE NSC (07)WI 
000047382MEDICARE PIN (08)WI 
38726800MEDICAID (05)WI 
1487726535OTHER (01)INDIVIDUAL NPI NUMBER

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
26715754
Accepts Medicare Assignment
YES
Specialities List
Optometrist, Optician.
Competitive Bidding
NO

Supplies List

  • Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
  • Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1376724377, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
6
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
2
Unchanged
Pos 7
4
Doubled → 8
Pos 8
3
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 7 → 14 → 5 4 → 8 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 4 + 6 + 1 + 4 + 2 + 8 + 3 + 1 + 4 + 24 = 63

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 63 is 70. The difference is the calculated check digit.

70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1376724377.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1376724377, enumerated as an "organization" on November 18, 2007.

The provider is located at 1674 OLD SCHOOLHOUSE RD SUITE 101 OCONOMOWOC, WI 53066 and the phone number is (262) 567-2295.

Optometrist with taxonomy code 152W00000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Blue Cross and. Please consult your insurance carrier or call the provider to verify.