Midwest Eye Laboratories Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MIDWEST EYE LABORATORIES INC

Practice address

4606 Commerce Valley Rd
Suite 201
Eau Claire, WI 54701-7075

Phone

(715) 833-2277

Fax

(715) 833-2295

NPI assigned

Apr 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael R Barrett, B.C.O.

Title

President Ocularist

Phone

(715) 833-2277

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Midwest Eye Laboratories Inc

  • Prosthetic/Orthotic Supplier
  • Wausau, WI
  • NPI 1841417169

  0042338303

  Same PAC ID
• Midwest Eye Laboratories Inc

  • Prosthetic/Orthotic Supplier
  • Rochester, MN
  • NPI 1265659577

  0042338303

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Midwest Eye Laboratories Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Midwest Eye Laboratories Inc

  • Prosthetic/Orthotic Supplier
  • Wausau, WI
  • NPI 1841417169
  NPD tax ID
• Midwest Eye Laboratories Inc

  • Prosthetic/Orthotic Supplier
  • Rochester, MN
  • NPI 1265659577
  NPD tax ID

Locations

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544659200000",
    "number": "1386861367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 COMMERCE VALLEY RD",
            "address_2": "SUITE 201",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017075",
            "telephone_number": "715-833-2277",
            "fax_number": "715-833-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 COMMERCE VALLEY RD",
            "address_2": "SUITE 201",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017075",
            "telephone_number": "715-833-2277",
            "fax_number": "715-833-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EYE LABORATORIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2018-12-13",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT OCULARIST",
        "authorized_official_telephone_number": "715-833-2277",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.C.O."
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0943035",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841416062",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "503306300",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38430000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael J Smith MD SC
• Koren Mickelson
• Rachael J Mickelson, BA
• Mickey Crothers, PH.D., LLC
• Samantha Marie Middleton, DPT
• Midwest Neurotech, LLC
• Ndome Ezantyi Mienlame
• James B Miettunen, MD
• Michelle J Miland, NP
• Jamie Lynn Milanowski

• Prosthetic/Orthotic Supplier in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Prosthetic/Orthotic Supplier in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.