Individual provider Active NPI

Rosemarie M Brueggeman, MD

  • Ophthalmology Physician
  • Milwaukee, WI
National Provider Identifier
1306825674
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
44926 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy
Ste 170
Milwaukee, WI 53215
Phone
(414) 385-1277
Fax
(414) 385-8730
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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 44926 WI Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy
Ste 170
Milwaukee, WI 53215

Mailing address

2801 W Kinnickinnic River Pkwy
Ste 170
Milwaukee, WI 53215-3669
Phone (414) 385-1277

Other identifiers 1

IdentifierTypeStateIssuer
34249800MedicaidWI

Other names 1

  • Rosemarie M Mendivil Former name

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
I20050818000599 WI Practitioner - Ophthalmology 6002846029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Physician Associates SCGroup PAC ID 9931171402, 8 clinicians

Practice addresses (Care Compare)

1249 W Liebau Rd
Suite 102
Mequon, WI 53092-3397
Phone (414) 928-2020

13111 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7373

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 928-2020

4300 W Layton Ave
Suite 100
Greenfield, WI 53220-4136
Phone (414) 928-2020

8375 S Howell Ave
Suite 204
Oak Creek, WI 53154-8344
Phone (414) 928-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.71 of 100Reported as group
Quality
83.61
Improvement activities
40
Cost
70.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery250

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44926WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Physician Associates, S.C. Ophthalmology CurrentSince Nov 1, 2002 Accepting new patients
Eye Physician Associates, S.C. Ophthalmology CurrentSince Nov 1, 2002 Accepting new patients
Dr K F Nassif & Associates SC Ophthalmology PastSince Mar 7, 1997 Accepting new patients

Locations

1249 W Liebau Rd
Ste 102
Mequon, WI 53092
Phone (414) 481-8828

4300 W Layton Ave
#100
Milwaukee, WI 53220
Phone (414) 260-0789

2801 W Kinnickinnic River Pkwy
Ste 170
Milwaukee, WI 53215
Phone (414) 385-1277

8375 S Howell Ave
Ste 204
Oak Creek, WI 53154
Phone (414) 928-2020

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

10625 W North Ave
Ste 200
Wauwatosa, WI 53226
Phone (414) 258-6880

Interoperability endpoints

  • Direct secure messaging: roseb@epasc1966.srs-direct.com

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.

Hospital & facility affiliations 3

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1306825674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY",
            "address_2": "STE 170",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153669",
            "telephone_number": "414-385-1277",
            "fax_number": "414-385-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY",
            "address_2": "STE 170",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-385-1277",
            "fax_number": "414-385-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUEGGEMAN",
        "first_name": "ROSEMARIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "44926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34249800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSEMARIE",
            "last_name": "MENDIVIL",
            "middle_name": "M",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.