Advanced Eyecare Center, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1957 Issued in WI

Legal business name

ADVANCED EYECARE CENTER, LLC

Doing business as

Advanced Eyecare Center

Practice address

3237 Riverside Dr Ste a
Green Bay, WI 54301-1643

Phone

(920) 336-2020

Fax

(920) 336-2709

NPI assigned

Jul 1, 2006

Last updated

Dec 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Candice Madaski

Title

Billing/Credentialing MNGR

Phone

(920) 336-2020

Specialties & licenses 2

Addresses

Other names 1

• Advanced Eyecare Center Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ann Meier Carli, O.D.

  • Optometrist
  • Green Bay, WI
  • NPI 1437191293
  Medicare reassignment Care Compare group NPD
• Glenn David Carli, O.D.

  • Optometrist
  • Green Bay, WI
  • NPI 1619914181
  Medicare reassignment Care Compare group NPD
• John Carli, OD

  • Optometrist
  • Green Bay, WI
  • NPI 1174201966
  Medicare reassignment Care Compare group NPD
• Joshua D Carli, OD

  • Optometrist
  • Green Bay, WI
  • NPI 1235814906
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1174552376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3237 RIVERSIDE DR STE A",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543011643",
            "telephone_number": "920-336-2020",
            "fax_number": "920-336-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3237 RIVERSIDE DR STE A",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543011643",
            "telephone_number": "920-336-2020",
            "fax_number": "920-336-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYECARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "MADASKI",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING MNGR",
        "authorized_official_telephone_number": "920-336-2020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2070",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Eyecare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Lynn Adelman, MSW
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• Optometrist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.