Individual provider Active NPI

Stuart W Natale, OD

  • Optometrist
  • Saukville, WI
National Provider Identifier
1427116375
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
WI2716035 Issued in WI
Practice address
289 E Green Bay Ave
Saukville, WI 53080
Phone
(262) 268-2007
Fax
(262) 268-8279
NPI assigned
Dec 4, 2006
Last updated
Aug 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X WI2716035 WI Primary

Addresses

Primary practice location

289 E Green Bay Ave
Saukville, WI 53080

Mailing address

289 E Green Bay Ave
Saukville, WI 53080
Phone (262) 268-2007

Other identifiers 1

IdentifierTypeStateIssuer
38604600MedicaidWI

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040521000053 WI Practitioner - Optometry 6709877418 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WI2716035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Family Vision SC CurrentSince Sep 21, 2009 Accepting new patients
Stein Optical Inc. Optometrist Past Accepting new patients

Locations

309 N Franklin St
Port Washington, WI 53074
Phone (262) 261-5252

289 E Green Bay Ave
Saukville, WI 53080
Phone (262) 268-2007

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1427116375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 E GREEN BAY AVE",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "53080",
            "telephone_number": "262-268-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 E GREEN BAY AVE",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "53080",
            "telephone_number": "262-268-2007",
            "fax_number": "262-268-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATALE",
        "first_name": "STUART",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "WI2716035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38604600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saukville, WI

Sources for this page

Verify at the official NPI Registry.