Marissa Spatz
Individual provider Active NPI Optometrist · Oconto, WI
NPI 1669360780 · NPPES record last updated Jun 26, 2025
Key facts
- NPI
- 1669360780
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4077-35 (WI)
- Practice address
- 155 Memorial Dr
Oconto, WI 54153-2053 - Phone
- (920) 516-7107
- NPI assigned
- Jun 26, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
Organizations & group practices 15
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Lakes Community Health Center Inc
Practice addresses (Care Compare)
7665 US Hwy 2
Iron River, WI 54847-4690
Phone (715) 372-5001
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250825003308 | WI | Practitioner - Optometry | 1254831167 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4077-35 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Lakes Community Health Center, Inc | Current |
Accepting new patients | |
| The Lakes Community Health Center, Inc | Current |
Accepting new patients | |
| The Lakes Community Health Center, Inc | Past | Accepting new patients |
Locations
300 Main St W
Ashland, WI 54806
Phone (715) 685-2200
15735 W US Highway 63
Hayward, WI 54843
7665 US Highway 2
Iron River, WI 54847
Phone (715) 372-5001
155 Memorial Dr
Oconto, WI 54153
Phone (920) 516-7107
Interoperability endpoints
- mspatz809220@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4077-35 | WI | Yes |
Addresses
Primary practice location
155 Memorial Dr
Oconto, WI 54153-2053
Mailing address
1730 Cinnabar Way
Green Bay, WI 54311-4000
Other providers in Oconto, WI
- David Schreiter
- Shopko #602
- Shopko Stores Operating Co LLC
- Shopko Stores Operating Co LLC
- Joshua M Simpson
- St Clare Memorial Hospital, Inc
- St Vincent Hospital-Hospital Sisters-Third Order of St Francis
- St Vincent Hospital-Hospital Sisters-Third Order of St Francis
- Elizabeth R Stukenberg
- The Lakes Community Health Center, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.