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Active NPI 1114043387 Individual Practitioner Male Practitioner

Dr. Thomas G Peterson , OD

Optometrist • Shawano, WI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Peterson, OD is a certified Optometrist practicing in Shawano, WI. With approximately 37 years of clinical experience since graduating from University Of Missouri St Louis - School Of Optometry in 1989, Dr. Peterson delivers high-quality medical care to the local community at 150A COUNTY ROAD B.

Dr. Peterson maintains professional affiliations with Shoptikal Llc, 1 Vision S.C. and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, photography of the retina, imaging of retina. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

150a County Road B

Shawano, WI 54166

Telephone 7155263163
Fax 7155264019
Associated Practice Facility / Clinic
🏢 1 Vision S.c. Facility NPI 1033197397

Medicare Profile & Education

Medical School

University Of Missouri St Louis - School Of Optometry

Graduation Year

1989

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Shawano, WI

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
37 Yrs +11.4 yrs vs City Avg
City Avg: 25.6 Yrs
State Avg: 21.0 Yrs
Regional Practice Density
8 Specialists

Practicing in Shawano, WI (1196 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
53.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Peterson (37 Years) 37 Yrs
Shawano Specialty Average (25.6 Years) 25.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
164 137 $158.90 $120.59
92250 Photography of the retina
40 39 $118.75 $34.27
92134 Imaging of retina
39 35 $199.23 $38.06
92133 Imaging of optic nerve
34 34 $198.68 $33.89
99213 Established patient office or other outpatient visit, typically 15 minutes
32 24 $140.00 $85.46
92083 Exam of visual field with extended testing
22 14 $100.00 $59.85
92014 Established patient complete exam of visual system
20 20 $140.00 $115.99

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License WI 2324

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
38578000 (WI)
Commercial Insurance / Payer ID Railroad Medicare
410033786 (WI)

Hospital & Practice Group Affiliations

Shoptikal Llc

2325 Neva Rd, Antigo, WI 544092912

Phone: 7156233620

1 Vision S.c.

150 A County Rd B, Shawano, WI 541667072

Phone: 7155263163

1 Vision S.c.

136 S Main St, Clintonville, WI 549291631

Phone: 7158232020

1 Vision S.c.

810 5th Ave, Antigo, WI 544091937

Phone: 7156233620

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1134641848

Doctor of Optometry

NPI 1447489661

Doctor of Optometry

NPI 1821063009

Doctor of Optometry

NPI 1932580537

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Business Mailing Address July 22, 2018

Registered at 150A COUNTY ROAD B, SHAWANO, WI 541667072 (Tel: 7155263163)

📍
Updated Practice Location June 28, 2018

Registered at 150A COUNTY ROAD B, SHAWANO, WI 54166 (Tel: 7155263163)

📍
Updated Business Mailing Address June 28, 2018

Registered at PO BOX 513, SHAWANO, WI 541660513 (Tel: 7155263163)

NPI Profile Active April 15, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location April 15, 2008

Registered at 115 ALPINE CT, SHAWANO, WI 541662041 (Tel: 7155263163)

📍
Updated Business Mailing Address April 15, 2008

Registered at 115 ALPINE CT, P.O. BOX 513, SHAWANO, WI 541662041 (Tel: 7155263163)

👤
Provider Name / Credentials Updated April 15, 2008

Recorded as THOMAS PETERSON, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 15, 2008

Optometrist (License #2324 in WI)

🟢
Initial NPI Registration & Enumeration March 21, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114043387
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 21, 2007
Last Update: July 22, 2018
Sole Proprietor: No

Mailing Address

150a County Road B

Shawano, WI 541667072

Phone: 7155263163

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.