Active NPI
George J. Witteman, M.D.
- Ophthalmology Physician
- Wausau, WI
National Provider Identifier
1528041357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 20653
- Practice address
- 614 1St St
Wausau, WI 54403-4851 - Phone
- (715) 845-8201
- Fax
- (715) 848-1722
- NPI assigned
- Nov 25, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 20653 | WI | Primary |
Addresses
Primary practice location
614 1St St
Wausau, WI 54403-4851
Mailing address
614 1St St
Wausau, WI 54403-4851
Phone (715) 845-8201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30112500 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20653 | WI | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1528041357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 1ST ST",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544034851",
"telephone_number": "715-845-8201",
"fax_number": "715-848-1722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 1ST ST",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544034851",
"telephone_number": "715-845-8201",
"fax_number": "715-848-1722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTEMAN",
"first_name": "GEORGE",
"middle_name": "J.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-25",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "WI",
"license": "20653",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30112500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.