Active NPI
Robin S Wilson, M.D.
- Ophthalmology Physician
- Brookfield, WI
National Provider Identifier
1316930845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 26077
- Practice address
- 17280 W North Avenue
Suite 100
Brookfield, WI 53045 - Phone
- (414) 271-2020
- Fax
- (262) 786-0084
- NPI assigned
- Aug 30, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 26077 | WI | Primary |
Addresses
Primary practice location
17280 W North Avenue
Suite 100
Brookfield, WI 53045
Mailing address
1684 N Prospect Ave
Milwaukee, WI 53202
Phone (414) 271-2020
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4047311 | Other | WI | AETNA |
| 26077020 | Other | WI | WI STATE LICENSE NUMBER |
| 30590400 | Medicaid | WI | |
| 2477923 | Other | WI | CIGNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26077 | WI | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milwaukee Eye Care Associates S.C. | Ophthalmology | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200441600000",
"number": "1316930845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1684 N PROSPECT AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "53202",
"telephone_number": "414-271-2020",
"fax_number": "414-272-3932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17280 W NORTH AVENUE",
"address_2": "SUITE 100",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "53045",
"telephone_number": "414-271-2020",
"fax_number": "262-786-0084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ROBIN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-30",
"last_updated": "2008-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "WI",
"license": "26077",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4047311",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WI STATE LICENSE NUMBER",
"identifier": "26077020",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30590400",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2477923",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.