Stephen Mark Waclawski, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1768-035 Issued in WI

Practice address

5312 S 27TH St
Milwaukee, WI 53221-3724

Phone

(414) 281-4800

Fax

(414) 281-4891

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Wisconsin LLCGroup PAC ID 5890033716, 27 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myeyedr Optometry of Wisconsin, LLC

  • Optometrist
  • Kenosha, WI
  • NPI 1164992996
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Wisconsin, LLC

  • Optometrist
  • New Berlin, WI
  • NPI 1659833218
  NPD
• Myeyedr Optometry of Wisconsin, LLC

  • Optometrist
  • West Allis, WI
  • NPI 1710632864
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1295832392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5312 S 27TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532213724",
            "telephone_number": "414-281-4800",
            "fax_number": "414-281-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5312 S 27TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532213724",
            "telephone_number": "414-281-4800",
            "fax_number": "414-281-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACLAWSKI",
        "first_name": "STEPHEN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1768-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "385130000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carly A Wabiszewski, NP
• Amy M Wachowiak, M.D.
• Kaley Marie Wachowiak
• Lindsay Wachowiak
• Michael Waclawski, OD
• Kara Lynn Waddell
• Shakeithia Wade-McGee
• Gwen E. Wade, RN
• Jeanette M Wade, NP
• Jenna Wade, M.D.

• 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 Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.