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ADVANCED FAMILY EYECARE
NPI 1578640223
Optometrist in Waupaca, WI

Active since November 01, 2006CLIA 52D2068161 · Waiver
308 W FULTON ST, WAUPACA, WI 54981(715) 258-8168(715) 258-8436 Get Directions Write a Review

NPPES record last updated: July 18, 2011. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Advanced Family Eyecare NPPES

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

ADVANCED FAMILY EYECARE (NPI 1578640223) is a healthcare organization registered as an optometrist in Waupaca, Wisconsin and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through January 25, 2027 and lists Daniel R Everts, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1578640223
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameADVANCED FAMILY EYECARE
Location Address308 W FULTON STWaupaca, WI 54981-1422
Mailing Address308 W Fulton StWaupaca, WI 54981-1422 · (715) 258-8168 · Fax (715) 258-8436
Phone(715) 258-8168
Fax(715) 258-8436
Organization SubpartNo
Authorized OfficialDaniel R EvertsOwner/president · (715) 258-8168
Enumeration DateNovember 1, 2006
Last NPPES UpdateJuly 18, 2011
✔ NPI 1578640223 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 · 2753
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.
308 W FULTON ST, Waupaca, WI 54981
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Other Identifiers 3

Medicare NSC0187380001WI
Medicare ID-Type Unspecified000047540WI
Medicaid38716100WI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, BlueCross BlueShield of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advanced Family Eyecare is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Advanced Family Eyecare, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Cody Dagnall, OD
Optometry
NPI 1851036867
308 W FULTON ST # 1422
Waupaca, WI 54981
(715) 258-8168
✔ PECOS✔ Accepts MedicareSame address
Daniel Everts, OD
Optometry
NPI 1811968878
308 W FULTON ST
Waupaca, WI 54981
(715) 258-8168
✔ PECOS✔ Accepts MedicareSame address
Jake Pray, OD
Optometry
NPI 1508392465
105 N EARLE ST
Walhalla, SC 29691
(864) 638-9505
✔ PECOS✔ Accepts Medicare736 mi

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2068161

Advanced Family Eyecare · Waupaca, WI
Active · expires Jan 25, 2027
CLIA Number52D2068161
Laboratory TypePhysician Office
Certificate Effective DateJanuary 26, 2025
Certificate Expiration DateJanuary 25, 2027
Laboratory DirectorDr. Daniel R. Everts
Laboratory Phone(715) 258-8168
Laboratory LocationAdvanced Family Eyecare308 W Fulton Street, Waupaca, WI 54981
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Advanced Family Eyecare's NPI number?

The NPI number for Advanced Family Eyecare is 1578640223. It was assigned to this organization in the NPPES registry on November 1, 2006.

Where is Advanced Family Eyecare located?

Advanced Family Eyecare is located at 308 W Fulton St, Waupaca, WI 54981. The listed phone number is (715) 258-8168.

What is Advanced Family Eyecare's specialty?

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

Is Advanced Family Eyecare enrolled in Medicare?

Yes. Advanced Family Eyecare is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advanced Family Eyecare?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Optometry, reassign their Medicare billing to Advanced Family Eyecare. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Advanced Family Eyecare hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2068161) is associated with this NPI, valid through January 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Advanced Family Eyecare accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, BlueCross BlueShield of Tennessee, CareSource (Common Ground Healthcare) and HealthPartners and 2 other insurers list Advanced Family Eyecare 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 Advanced Family Eyecare was last updated on July 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.