Individual provider Active NPI

Emy Lutchka Boente, OD

  • Optometrist
  • Greenfield, WI
National Provider Identifier
1487376695
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3813-35 Issued in WI
Practice address
4300 W Layton Ave Ste 100
Greenfield, WI 53220-4136
Phone
(414) 928-2020
Fax
(414) 210-3402
NPI assigned
Sep 14, 2022
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3813-35 WI Primary

Addresses

Primary practice location

4300 W Layton Ave Ste 100
Greenfield, WI 53220-4136

Mailing address

4300 W Layton Ave Ste 100
Greenfield, WI 53220-4136
Phone (414) 928-2020

Other practice location 1

8375 S Howell Ave
Oak Creek, WI 53154-8344
Phone (414) 385-8725

Other practice location 2

1249 W Liebau Rd Ste 102
Mequon, WI 53092-3397
Phone (414) 385-8725

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
I20221121000754 WI Practitioner - Optometry 2769850916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Physician Associates SCGroup PAC ID 9931171402, 8 clinicians

Practice addresses (Care Compare)

1249 W Liebau Rd
Suite 102
Mequon, WI 53092-3397
Phone (414) 928-2020

13111 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7373

4300 W Layton Ave
Suite 100
Greenfield, WI 53220-4136
Phone (414) 928-2020

8375 S Howell Ave
Suite 204
Oak Creek, WI 53154-8344
Phone (414) 928-2020

Merit-based Incentive Payment System (MIPS)

Final score
84.71 of 100Reported as group
Quality
83.61
Improvement activities
40
Cost
70.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Physician Associates, S.C. Optometrist CurrentSince Sep 1, 2022 Accepting new patients
Eye Physician Associates, S.C. Optometrist CurrentSince Sep 1, 2022 Accepting new patients

Locations

1249 W Liebau Rd
Ste 102
Mequon, WI 53092
Phone (414) 481-8828

2801 W Kinnickinnic River Pkwy
Ste 140
Milwaukee, WI 53215
Phone (414) 385-8725

4300 W Layton Ave
#100
Milwaukee, WI 53220
Phone (414) 260-0789

8375 S Howell Ave
Ste 204
Oak Creek, WI 53154
Phone (414) 928-2020

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

Interoperability endpoints

  • Direct secure messaging: elutchka@epasc1966.srs-direct.com

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": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1487376695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W LAYTON AVE STE 100",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204136",
            "telephone_number": "414-928-2020",
            "fax_number": "414-210-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W LAYTON AVE STE 100",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204136",
            "telephone_number": "414-928-2020",
            "fax_number": "414-210-3402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8375 S Howell Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Creek",
            "state": "WI",
            "postal_code": "531548344",
            "country_code": "US",
            "telephone_number": "414-385-8725",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1249 W Liebau Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530923397",
            "country_code": "US",
            "telephone_number": "414-385-8725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTCHKA BOENTE",
        "first_name": "EMY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3813-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.