Eyes on the Lake

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYES ON THE LAKE

Practice address

2134 S Kinnickinnic Avenue
Milwaukee, WI 53207-1379

Phone

(414) 293-1180

Fax

(414) 293-1181

NPI assigned

Oct 20, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Vaugn Schneider, ODNPI 1124478144

Title

Optometrist / Owner

Phone

(920) 850-1367

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vaugn Schneider, O.D.

  • Optometrist
  • Milwaukee, WI
  • NPI 1124478144
  Medicare reassignment NPD Authorized official
• Katelyn Jo Steen, OD

  • Optometrist
  • Mount Pleasant, WI
  • NPI 1922655158
  Medicare reassignment NPD

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652918400000",
    "number": "1225791973",
    "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": "2160 S Kinnickinnic Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532071379",
            "country_code": "US",
            "telephone_number": "920-850-1367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EYES ON THE LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-20",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-04",
        "status": "A",
        "authorized_official_last_name": "SCHNEIDER",
        "authorized_official_first_name": "VAUGN",
        "authorized_official_title_or_position": "OPTOMETRIST / OWNER",
        "authorized_official_telephone_number": "920-850-1367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124478144",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eye Physician Associates, S.C.
• Eye Surgery & Laser Center of Wisconsin LLC
• Eye Surgery Associates, S.C.
• Eye-Care Home Health Care
• Eye-Care Home Health Care,LLC
• Ez Ride Transport
• Chimezirim Ezeano, MD
• Benjamin E Ezekiel, R.PH
• Isioma Jewel Ezekiel
• Marilyn D Ezri, MD

• Optometrist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.