Individual provider Active NPI

Julie Marie Zoellick, O.D.

  • Optometrist
  • Watertown, WI
National Provider Identifier
1437150588
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2936-035 Issued in WI
Practice address
1307 Memorial Dr
Watertown, WI 53098-3428
Phone
(920) 968-7546
Fax
(920) 328-1442
NPI assigned
Aug 10, 2005
Last updated
Jan 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2936-035 WI Primary

Addresses

Primary practice location

1307 Memorial Dr
Watertown, WI 53098-3428

Mailing address

1307 Memorial Dr
Watertown, WI 53098-3428
Phone (920) 968-7546

Other identifiers 1

IdentifierTypeStateIssuer
38620400MedicaidWI

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
I20040121000845 WI Practitioner - Optometry 0648172668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1307 Memorial Dr
Watertown, WI 53098-3428
Phone (920) 968-7546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2936-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Claris Eyecare LLC Optometrist CurrentSince Feb 23, 2018 Accepting new patients

Locations

1307 Memorial Dr
Watertown, WI 53098
Phone (920) 968-7546

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, 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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1437150588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 MEMORIAL DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983428",
            "telephone_number": "920-968-7546",
            "fax_number": "920-328-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 MEMORIAL DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983428",
            "telephone_number": "920-968-7546",
            "fax_number": "920-328-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOELLICK",
        "first_name": "JULIE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2936-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38620400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

Verify at the official NPI Registry.