Summit Eye Clinic SC
NPI 1679520845ActiveOrganization· Optometrist· Oconomowoc, WI
Optometrist in Oconomowoc, Wisconsin, registered in NPPES in May 2006. The authorized official on file is Randy J. Prestash, OD, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1679520845 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 31, 2006 |
| Last updated in NPPES | Mar 11, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 1780 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WI) |
|---|
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