Individual provider Active NPI

Kurt August Schwiesow, MD

  • Ophthalmology Physician
  • Green Bay, WI
National Provider Identifier
1215039136
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
46616020 Issued in WI
Practice address
1087 W Mason Street
Green Bay, WI 54303-1859
Phone
(920) 499-3102
Fax
(920) 499-9636
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 46616020 WI Primary

Addresses

Primary practice location

1087 W Mason Street
Green Bay, WI 54303-1859

Mailing address

1087 W Mason Street
Green Bay, WI 54303-1859
Phone (920) 499-3102

Other identifiers 1

IdentifierTypeStateIssuer
34538200MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kurt.schwiesow@towerclockeyecenter.direct.eyemdemr.com Direct

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040823000453 WI Practitioner - Ophthalmology 1951375377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Wisconsin School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tower Clock Eye Center SCGroup PAC ID 6305890781, 8 clinicians

Practice addresses (Care Compare)

1087 W Mason St
Green Bay, WI 54303-1859
Phone (920) 499-3102

Hospital & facility affiliations

  • Osf St Francis Hospital and Medical Group Hospital, Escanaba, MI, CCN 231337

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46616020WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Clock Eye Center SC Ophthalmology CurrentSince Jul 1, 2005 Accepting new patients
Tower Clock Eye Center SC Ophthalmology CurrentSince Jul 1, 2005 Accepting new patients

Locations

3142 N Richmond St
Appleton, WI 54911
Phone (920) 499-3102

1087 W Mason St
Green Bay, WI 54303
Phone (920) 499-3102

229 E Green Bay St
Shawano, WI 54166
Phone (920) 499-3102

Interoperability endpoints

  • Direct secure messaging: kurt.schwiesow@towerclockeyecenter.direct.eyemdemr.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1215039136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1087 W MASON STREET",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031859",
            "telephone_number": "920-499-3102",
            "fax_number": "920-499-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1087 W MASON STREET",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031859",
            "telephone_number": "920-499-3102",
            "fax_number": "920-499-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWIESOW",
        "first_name": "KURT",
        "middle_name": "AUGUST",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "46616020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34538200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kurt.schwiesow@towerclockeyecenter.direct.eyemdemr.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1087 W Mason Street",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543031859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.