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DR. ANDREW CONGDON O.D.
NPI 1467866509
Optometrist in Marinette, WI

Active since June 17, 2014PECOS EnrolledAccepts Medicare Assignment
3003 CLEVELAND AVE, A, MARINETTE, WI 54143(920) 883-0632 Get Directions Write a Review

NPPES record last updated: September 21, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Andrew Congdon O.d. NPPES

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

DR. ANDREW CONGDON O.D. (NPI 1467866509) is an individual optometrist in Marinette, Wisconsin, licensed in Wisconsin (3346-35) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2014).

NPPES Registry Identity

NPI1467866509
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. ANDREW CONGDONCredential: O.D.
Location Address3003 CLEVELAND AVE, AMarinette, WI 54143-3760
Mailing Address3000 Cleveland Ave, AMarinette, WI 54143-3760 · (715) 732-2101
Phone(920) 883-0632
Sole ProprietorYes
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2014
Enumeration DateJune 17, 2014
Last NPPES UpdateSeptember 21, 2023
NPPES CertifiedSeptember 21, 2023
✔ NPI 1467866509 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 · 3346-35
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.
3003 CLEVELAND AVE, Marinette, WI 54143
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana.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

Dr. Andrew Congdon O.d. 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 ID5698073823
PECOS Enrollment IDI20160420002647
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 10

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.
2,934 services19 patients
Complex removal of cataract with insertion of prosthetic lens 66982
This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.
1,559 services11 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.
266 services212 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
173 services156 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
83 services79 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).
49 services44 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54143 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.

Referred Medical Equipment & Supplies CMS DME claims 3

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 supplier29 claims29 services$53.37 avg. paid by Medicare
Sphere, trifocal, plano to plus or minus 4.00d, per lens V2300
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier11 claims21 services$41.01 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 supplier11 claims19 services$39.52 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 2

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

CONGDON OPTOMETRY INC
Technician/Technologist (Optician)
3003 CLEVELAND AVE, SUITE A
MARINETTE, WI 54143
Marinette County (715) 732-2101
DR. KEVIN CONGDON O. D.
Optometrist
3003 CLEVELAND AVE, SUITE A
MARINETTE, WI 54143
Marinette County (715) 732-2101

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 Andrew Congdon's NPI number?

The NPI number for Andrew Congdon is 1467866509. It was assigned to this individual provider in the NPPES registry on June 17, 2014.

Where is Andrew Congdon located?

Andrew Congdon practices at 3003 Cleveland Ave A, Marinette, WI 54143. The listed phone number is (920) 883-0632.

What is Andrew Congdon's specialty?

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

Is Andrew Congdon enrolled in Medicare?

Yes. Andrew Congdon 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 Andrew Congdon accept?

Health plans from Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Louisiana list Andrew Congdon 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 Andrew Congdon was last updated on September 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.