Northeast Wisconsin Retina Associates SC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

NORTHEAST WISCONSIN RETINA ASSOCIATES SC

Practice address

442 N Westhill Blvd Ste a
Appleton, WI 54914-5830

Phone

(920) 751-8666

Fax

(920) 751-0288

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Amy Debruin

Title

Billing Department Manager

Phone

(920) 751-8666

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: sagarwal-sinha@newretinamd.intellechartdirect.net
• Direct secure messaging: chejny@newretinamd.intellechartdirect.net
• Direct secure messaging: rbuddi@newretinamd.intellechartdirect.net
• Direct secure messaging: bernst@newretinamd.intellechartdirect.net

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Swati Agarwal-Sinha, MD

  • Ophthalmology Physician
  • Green Bay, WI
  • NPI 1659578623

  Retina Specialist

  Medicare reassignment Care Compare group NPD
• Rajeev Buddi, MD

  • Retina Specialist (Ophthalmology) Physician
  • Neenah, WI
  • NPI 1700819281
  Medicare reassignment Care Compare group NPD
• Benjamin John Ernst, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Appleton, WI
  • NPI 1518162247
  Medicare reassignment Care Compare group NPD
• Charles Hejny, MD

  • Retina Specialist (Ophthalmology) Physician
  • Neenah, WI
  • NPI 1922013671
  Medicare reassignment Care Compare group NPD
• Khalid S Kahook, M.D.,

  • Retina Specialist (Ophthalmology) Physician
  • Neenah, WI
  • NPI 1356640726
  Medicare reassignment Care Compare group NPD
• Anthony Parendo, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Appleton, WI
  • NPI 1043690233
  Medicare reassignment Care Compare group NPD
• Michael Edward Possin, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Appleton, WI
  • NPI 1811253289
  Medicare reassignment Care Compare group NPD
• Martin Viebahn, MD

  • Ophthalmology Physician
  • Neenah, WI
  • NPI 1164437802
  NPD (past)
• John R. Nordlund, M.D., PHD

  • Ophthalmology Physician
  • Williamsburg, VA
  • NPI 1841275831
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1437164175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 N WESTHILL BLVD STE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549145830",
            "telephone_number": "920-751-8666",
            "fax_number": "920-751-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 N WESTHILL BLVD STE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549145830",
            "telephone_number": "920-751-8666",
            "fax_number": "920-751-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST WISCONSIN RETINA ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "DEBRUIN",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "BILLING DEPARTMENT MANAGER",
        "authorized_official_telephone_number": "920-751-8666"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Norris, MD
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• Retina Specialist (Ophthalmology) Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Retina Specialist (Ophthalmology) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.