Individual provider Active NPI

Tracey J Strombeck, O.D.

  • Optometrist
  • Waukesha, WI
National Provider Identifier
1548417637
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3170-035 Issued in WI
Practice address
2315 E Moreland Blvd # West
Waukesha, WI 53186-2939
Phone
(262) 532-5700
Fax
(262) 532-5701
NPI assigned
Aug 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 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 3170-035 WI Primary

Addresses

Primary practice location

2315 E Moreland Blvd # West
Waukesha, WI 53186-2939

Mailing address

2315 E Moreland Blvd # West
Waukesha, WI 53186-2939
Phone (262) 532-5700

Other practice location 1

925 N 87th St
The Eye Institute
Milwaukee, WI 53226-4812
Phone (414) 955-2020

Other identifiers 1

IdentifierTypeStateIssuer
1548417637MedicaidWI

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
I20101129000932 WI Practitioner - Optometry 5395931695 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3170-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Optometrist CurrentSince Jun 4, 2012 Accepting new patients
Stein Optical Inc. Optometrist Past Accepting new patients
Children'S Specialty Group, Inc. Optometrist Past Accepting new patients
Eye Care Center of New Holstein, LLC Optometrist Past Accepting new patients

Locations

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

925 N 87th St
Milwaukee, WI 53226
Phone (414) 955-2020

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

2315 E Moreland Blvd
Waukesha, WI 53186
Phone (262) 532-5700

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Interoperability endpoints

  • Direct secure messaging: tstrombeck13422@direct.chw.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1548417637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 E MORELAND BLVD # WEST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531862939",
            "telephone_number": "262-532-5700",
            "fax_number": "262-532-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 E MORELAND BLVD # WEST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531862939",
            "telephone_number": "262-532-5700",
            "fax_number": "262-532-5701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 N 87th St",
            "address_2": "THE EYE INSTITUTE",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264812",
            "country_code": "US",
            "telephone_number": "414-955-2020",
            "fax_number": "414-955-6300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STROMBECK",
        "first_name": "TRACEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3170-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548417637",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.