AMANDA C LALLENSACK OD
NPI 1477178259
Optometrist in Crandon, WI

Q: What is Amanda Lallensack's NPI number?

The NPI number for Amanda Lallensack is 1477178259. It was assigned to this individual provider in the NPPES registry on June 8, 2020.

Q: What is Amanda Lallensack's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Amanda Lallensack was last updated on August 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 08, 2020PECOS EnrolledAccepts Medicare Assignment

8201 MISH KO SWEN DR, CRANDON, WI 54520(715) 478-4300 Get Directions Write a Review

NPPES record last updated: August 17, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 17, 2021, Jun 9, 2020 (2 updates tracked since 2020).

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About Amanda C Lallensack Od NPPES

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

AMANDA C LALLENSACK OD (NPI 1477178259) is an individual optometrist in Crandon, Wisconsin, licensed in Wisconsin (3700) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1477178259

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameAMANDA C LALLENSACKCredential: OD

Location Address8201 MISH KO SWEN DRCrandon, WI 54520-8631

Mailing AddressPo Box 396Crandon, WI 54520-0396 · (715) 478-4300

Phone(715) 478-4300

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateJune 8, 2020

Last NPPES UpdateAugust 17, 20212 updates tracked since enumeration

NPPES CertifiedAugust 17, 2021

✔ NPI 1477178259 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 · 3700

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.

8201 MISH KO SWEN DR, Crandon, WI 54520

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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, Aspirus Health Plan, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amanda C Lallensack 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 ID941626261

PECOS Enrollment IDI20210907002469

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.

Medicare Billing Reassignments

Medicare enrollment records show Amanda Lallensack reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Forest County Potawatomi Community

Same address

Federally Qualified Health Center (FQHC)

8201 MISH KO SWEN DRIVE
Crandon, WI 54520

Reassigned Medicare billing, Wisconsin enrollment
31 clinicians in this Medicare group

NPI 1285741306 (715) 478-4300

Santa Ana Health Center

1,165 mi

Health Service

02C DOVE ROAD
Bernalillo, NM 87004

Reassigned Medicare billing, Texas enrollment
65 clinicians in this Medicare group

NPI 1649331323 (505) 867-2497

Albuquerque Indian Health Center

1,180 mi

Clinic/Center

801 VASSAR DR NE
Albuquerque, NM 87106

Reassigned Medicare billing, Texas enrollment
133 clinicians in this Medicare group

NPI 1659458917 (505) 248-4062

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

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.

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.

60 services60 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

25 services25 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.

16 services11 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.

15 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54520 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.

Other Providers at the Same Location NPPES 20

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

JACKLIN A SAILO FNP

Nurse Practitioner (Family)