Active NPI
David Richard Luellwitz, D.O.
- Glaucoma Specialist (Ophthalmology) Physician
- Janesville, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Glaucoma Specialist (Ophthalmology) Physician
- License
- 45377
- Practice address
- 3524 E Milwaukee St
Janesville, WI 53546-1626 - Phone
- (608) 756-7110
- Fax
- (608) 756-7106
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 45377 | WI | |
| Glaucoma Specialist (Ophthalmology) Physician | 207WX0009X | 45377 | WI | Primary |
| Glaucoma Specialist (Ophthalmology) Physician | 207WX0009X | 036110948 | IL | |
| Ophthalmology Physician | 207W00000X | 036110948 | IL |
Addresses
Primary practice location
3524 E Milwaukee St
Janesville, WI 53546-1626
Mailing address
3524 E Milwaukee St
Janesville, WI 53546-1626
Phone (608) 756-7110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43505100 | Medicaid | WI |
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: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45377 | WI | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
3524 E Milwaukee St
Janesville, WI 53546
Phone (608) 756-7100
N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba MHS Physician Services
- Multi-Specialty Clinic/Center
- Janesville, WI
- NPI 1598718603
-
dba Mercy Hospital Janesville
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
-
dba Mercy Walworth Hospital and Medical Center
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491436800000",
"number": "1518066554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3524 E MILWAUKEE ST",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535461626",
"telephone_number": "608-756-7110",
"fax_number": "608-756-7106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3524 E MILWAUKEE ST",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535461626",
"telephone_number": "608-756-7110",
"fax_number": "608-756-7106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUELLWITZ",
"first_name": "DAVID",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2017-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "WI",
"license": "45377",
"primary": false
},
{
"code": "207WX0009X",
"taxonomy_group": "",
"desc": "Ophthalmology, Glaucoma Specialist",
"state": "WI",
"license": "45377",
"primary": true
},
{
"code": "207WX0009X",
"taxonomy_group": "",
"desc": "Ophthalmology, Glaucoma Specialist",
"state": "IL",
"license": "036110948",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IL",
"license": "036110948",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43505100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Janesville, WI
- Lotus Counseling, LLC (Lotus)
- Kimberley R. Lovelace, MD
- Gabriela Loveland
- Lorna Lovett, RD
- Jonathan Alexander Lubin, MD
- Kimberly M Lunaas, MD
- Dennis J Luster, LPC
- Lutheran Social Services of Wisconsin and Upper Michigan, Inc. (LSS Janesville Clinic)
- Luxottica of America Inc. (Lenscrafters #540)
- Eric R Lyerla, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.