Organization Active NPI

Griebenow Eyecare, S.C.

  • Optometrist
  • Clintonville, WI
National Provider Identifier
1003045402
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1666 Issued in WI
Legal business name
GRIEBENOW EYECARE, S.C.
Practice address
45 10TH St.
Clintonville, WI 54929
Phone
(715) 823-5112
Fax
(715) 823-5959
NPI assigned
Jul 7, 2009
Organization subpart
Yes
Parent organization
GRIEBENOW EYECARE, S.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Melissa Sylte
Title
Business Manager
Phone
(920) 982-3711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1666 WI Primary

Addresses

Primary practice location

45 10TH St.
Clintonville, WI 54929

Mailing address

PO Box 230
New London, WI 54961-0230
Phone (920) 982-3711

Other names 1

  • Griebenow Eyecare Clintonville Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clintonville@griebenoweyecare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050120000809 WI Part B Supplier - Clinic/Group Practice 0941259501 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clintonville, WI; New London, WI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2315438Griebenow Eyecare45 10TH St, Clintonville, WI 54929Certificate of waiverDec 11, 2026

National Provider Directory

National Provider Directory
Part of
Griebenow Eyecare SC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1003045402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549610230",
            "telephone_number": "920-982-3711",
            "fax_number": "715-823-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 10TH ST.",
            "city": "CLINTONVILLE",
            "state": "WI",
            "postal_code": "54929",
            "telephone_number": "715-823-5112",
            "fax_number": "715-823-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIEBENOW EYECARE, S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRIEBENOW EYECARE, S.C.",
        "enumeration_date": "2009-07-07",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "SYLTE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "920-982-3711"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clintonville@griebenoweyecare.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "45 10th St.",
            "city": "Clintonville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Griebenow Eyecare Clintonville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Griebenow Eyecare Clintonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clintonville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.