Marissa Spatz

Primary specialty

OptometristTaxonomy code 152W00000X

License

4077-35 Issued in WI

Practice address

155 Memorial Dr
Oconto, WI 54153-2053

Phone

(920) 516-7107

NPI assigned

Jun 26, 2025

Last updated

Jun 26, 2025By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Lakes Community Health Center IncGroup PAC ID 0840366654, 104 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mspatz809220@direct.ochin.org

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.

• The Lakes Community Health Center, Inc

  dba NorthLakes Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Iron River, WI
  • NPI 1811178825
  Medicare reassignment Care Compare group NPD
• The Lakes Community Health Center, Inc

  dba NorthLakes Community Clinic

  • Federally Qualified Health Center (FQHC)
  • White Lake, WI
  • NPI 1679983423
  NPD
• The Lakes Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Lakewood, WI
  • NPI 1699778233
  NPD (past)

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

{
    "created_epoch": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1669360780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 CINNABAR WAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MEMORIAL DR",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541532053",
            "telephone_number": "920-516-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPATZ",
        "first_name": "MARISSA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "4077-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Schreiter, CSAC
• Shopko #602
• Shopko Stores Operating Co LLC (ShopKo Optical 602)
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 602)
• Joshua M Simpson, DMD
• St Clare Memorial Hospital, Inc (St Clare Memorial Hospital Oconto Health Center)
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis (Prevea Health-Oconto DME Supplier)
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis (St. Vincent Hospital-Libertas of Oconto)
• Elizabeth R Stukenberg, DNP, APNP, FNP-BC
• The Lakes Community Health Center, Inc (NorthLakes Community Clinic)

• Optometrist in Oconto, WI
• Providers in Oconto, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.