NPIMap

Organization Active NPI

Medical Eye Associates, S.C.

  • Ophthalmology Physician
  • Waukesha, WI
National Provider Identifier
1023066636
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
18333020 Issued in WI
Legal business name
MEDICAL EYE ASSOCIATES, S.C.
Practice address
N19W23993 Ridgeview Pkwy W Ste 100
Waukesha, WI 53188-1031
Phone
(262) 547-3352
Fax
(262) 547-9142
NPI assigned
May 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Authorized official

Name
Deborah Bernstein, M.D.NPI 1326005919
Title
President
Phone
(262) 547-3352

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 18333020 WI Primary

Addresses

Primary practice location

N19W23993 Ridgeview Pkwy W Ste 100
Waukesha, WI 53188-1031

Mailing address

N19W23993 Ridgeview Pkwy W Ste 100
Waukesha, WI 53188-1031
Phone (262) 547-3352

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000184 WI Part B Supplier - Clinic/Group Practice 0941195036 Receives reassigned benefits from 8 practitioners
Practice locations: Mukwonago, WI; Oconomowoc, WI; Waukesha, WI; Wauwatosa, WI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Medical Eye Assoc SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1111 Delafield St
Ste 312
Waukesha, WI 53188
Phone (262) 547-3352

1111 Delafield St
Waukesha, WI 53188
Phone (262) 542-0074

Practitioners & affiliated clinicians

Practitioners 11

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": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703548800000",
    "number": "1023066636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N19W23993 RIDGEVIEW PKWY W STE 100",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881031",
            "telephone_number": "262-547-3352",
            "fax_number": "262-547-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N19W23993 RIDGEVIEW PKWY W STE 100",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881031",
            "telephone_number": "262-547-3352",
            "fax_number": "262-547-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL EYE ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A",
        "authorized_official_last_name": "BERNSTEIN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-547-3352",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "18333020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.