Tracy Lynn Kocemba, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2684-035 Issued in WI

Practice address

15936 US Highway 63
Hayward, WI 54843-7162

Phone

(715) 634-1028

Fax

(715) 634-9733

NPI assigned

Nov 15, 2005

Last updated

Feb 23, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Tracy Lynn Scott Former name

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northview Eye Associates LLCGroup PAC ID 3577836006, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northview Eye Associates LLC

  • Optometrist
  • Rice Lake, WI
  • NPI 1215465083
  Medicare reassignment Care Compare group NPD
• Thomas Eric Herzog Inc

  dba Indianhead Eye Clinic

  • Clinic/Center
  • Spooner, WI
  • NPI 1902887508
  NPD (past)
• Vision Pro

  • Optometrist
  • Superior, WI
  • NPI 1013161645
  NPD (past)
• Vision Pro II Inc

  • Optometrist
  • Duluth, MN
  • NPI 1982756789
  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1467434647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15936 US HIGHWAY 63",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548437162",
            "telephone_number": "715-634-1028",
            "fax_number": "715-634-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15936 US HIGHWAY 63",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548437162",
            "telephone_number": "715-634-1028",
            "fax_number": "715-634-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCEMBA",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2684-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "P00069305",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE AT INDIANHEAD",
            "identifier": "874300004",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38600700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "SCOTT",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Constance M Kelsey, SLP
• Kathleen Ann Kephart
• Susan L Kettler, MSSW, LCSW
• Thomas Lee Kintzinger, M.D.
• Kellan Brett Klubben, MD
• Martha Krasean, RN, CNP
• Jessica Marie Kratz, PA-C
• Kelsey Kreyer, PHARMD
• Theodore Allen Kuhns, CNA
• Krista Kurtti

• Optometrist in Hayward, WI
• Providers in Hayward, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.