NPIMap

Organization Active NPI

Eye Physicians and Surgeons SC

  • Ophthalmology Physician
  • Elkhorn, WI
National Provider Identifier
1508949181
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE PHYSICIANS AND SURGEONS SC
Practice address
1311 S Lincoln St
Elkhorn, WI 53121-4375
Phone
(262) 723-4600
Fax
(262) 947-4996
NPI assigned
Oct 24, 2006
Last updated
Dec 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Authorized official

Name
Matthew Alan Dahlgren, MDNPI 1154371367
Title
President
Phone
(262) 723-4600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1311 S Lincoln St
Elkhorn, WI 53121-4375

Mailing address

1311 S Lincoln St
Elkhorn, WI 53121-4375
Phone (262) 723-4600

Electronic endpoints 6

TypeEndpointUseAffiliation
Direct Messaging Address mbrower@eps.emadirect.md Direct
Direct Messaging Address dsolverson@eps.emadirect.md Direct
Direct Messaging Address mdahlgren@eps.emadirect.md Direct
Direct Messaging Address nmathews@eps.emadirect.md Direct
Direct Messaging Address hahmadi@eps.emadirect.md Direct
Direct Messaging Address nveith@eps.emadirect.md Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090604000628 WI Part B Supplier - Clinic/Group Practice 6608926084 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Burlington, WI; Elkhorn, WI
O20100930053271 WI DME Supplier - Physician - Ophthalmology 6608926084 Practice locations: Elkhorn, WI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Eye Physicians and Surgeons3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: dsolverson@eps.emadirect.md
  • Direct secure messaging: hahmadi@eps.emadirect.md
  • Direct secure messaging: nmathews@eps.emadirect.md
  • Direct secure messaging: nveith@eps.emadirect.md

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1508949181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 S LINCOLN ST",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214375",
            "telephone_number": "262-723-4600",
            "fax_number": "262-723-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 S LINCOLN ST",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214375",
            "telephone_number": "262-723-4600",
            "fax_number": "262-947-4996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE PHYSICIANS AND SURGEONS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "DAHLGREN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-723-4600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbrower@eps.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1311 S Lincoln St",
            "city": "Elkhorn",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531214375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsolverson@eps.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1311 S Lincoln St",
            "city": "Elkhorn",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531214375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdahlgren@eps.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1311 S Lincoln St",
            "city": "Elkhorn",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531214375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmathews@eps.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1311 S Lincoln St",
            "city": "Elkhorn",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531214375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hahmadi@eps.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1311 S Lincoln St",
            "city": "Elkhorn",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531214375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nveith@eps.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1311 S Lincoln St",
            "city": "Elkhorn",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531214375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elkhorn, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.