Individual provider Active NPI

Vaugn Schneider, O.D.

  • Optometrist
  • Milwaukee, WI
National Provider Identifier
1124478144
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3416 Issued in WI
Practice address
2134 S Kinnickinnic Avenue
Milwaukee, WI 53207-1379
Phone
(414) 293-1180
Fax
(414) 293-1181
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3416 WI Primary

Addresses

Primary practice location

2134 S Kinnickinnic Avenue
Milwaukee, WI 53207-1379

Mailing address

2134 S Kinnickinnic Avenue
Milwaukee, WI 53207-1379
Phone (414) 293-1180

Other practice location 1

8693 N Port Washington Rd
Fox Point, WI 53217-2209
Phone (414) 351-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160922001391 WI Practitioner - Optometry 7416244256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2134 S Kinnickinnic Ave
Milwaukee, WI 53207-1328
Phone (414) 293-1180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3416WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Swift Optometry Care PC Optometrist CurrentSince Apr 1, 2024 Accepting new patients
Eyes on the Lake Optometrist CurrentSince Jun 1, 2022 Accepting new patients
Eyes on the Lake, PC Optometrist PastSince May 22, 2022 Accepting new patients

Locations

250 Skillman St
Ste 202
Brooklyn, NY 11205

430 Wilcox St
Fort Atkinson, WI 53538
Phone (920) 563-5533

2134 S Kinnickinnic Ave
Milwaukee, WI 53207
Phone (414) 293-1180

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1124478144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2134 S KINNICKINNIC AVENUE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532071379",
            "telephone_number": "414-293-1180",
            "fax_number": "414-293-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2134 S KINNICKINNIC AVENUE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532071379",
            "telephone_number": "414-293-1180",
            "fax_number": "414-293-1181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8693 N Port Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Fox Point",
            "state": "WI",
            "postal_code": "532172209",
            "country_code": "US",
            "telephone_number": "414-351-2020",
            "fax_number": "414-351-2031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "VAUGN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.