M Thomas Chemotti, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

21631 Issued in WI

Practice address

N54W6135 Mill St
Cedarburg, WI 53012-2021

Phone

(262) 377-8118

NPI assigned

Mar 14, 2006

Last updated

Nov 13, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Shore Eye Health and Wellness, SC

  dba North Shore Eye Health and Wellness

  • Optometrist
  • Cedarburg, WI
  • NPI 1629494703
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258070400000",
    "number": "1003885914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 503",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530120503",
            "telephone_number": "262-377-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N54W6135 MILL ST",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122021",
            "telephone_number": "262-377-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEMOTTI",
        "first_name": "M THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2009-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "21631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MD LICENSE",
            "identifier": "21631",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cedarburg Physical Therapy, Inc
• Cedarburg Prescription Center Inc (North Shore Pharmacy)
• Cedarburg Prescription Center, Inc (LTC North Shore Pharmacy & Compounding Center)
• Cedarburg School District
• Catherine Charlton, D.C.
• Gregory A Cherbukovsky, P.T.A.
• Children's Medical Group (Cedarburg Pediatrics)
• Chiropractic Company - Cedarburg LTD
• Sara Beck Cincotta, MS-CCC-SLP
• City of Cedarburg

• Ophthalmology Physician in Cedarburg, WI
• Providers in Cedarburg, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.