Ophthalmology Associates S C

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

OPHTHALMOLOGY ASSOCIATES S C

Practice address

6080 S 108TH St
Hales Corners, WI 53130-2557

Phone

(414) 425-9002

NPI assigned

Feb 20, 2007

Last updated

Oct 25, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Glenn Graves, MDNPI 1780671677

Title

Owner Partner

Phone

(414) 294-4660

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Ophthalmology Associates S C

  • Ophthalmology Physician
  • Cudahy, WI
  • NPI 1063557890

  O20040301000212

  Same enrollment
• Ophthalmology Associates S C

  • Ophthalmology Physician
  • Milwaukee, WI
  • NPI 1255476099

  O20040301000212

  Same enrollment
• Ophthalmology Associates S C

  • Ophthalmology Physician
  • Greenfield, WI
  • NPI 1720543614

  O20040301000212

  Same enrollment
• Ophthalmology Associates S C

  • Ophthalmology Physician
  • New Berlin, WI
  • NPI 1730224585

  O20040301000212

  Same enrollment

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Glenn E. Graves, M.D.

  • Glaucoma Specialist (Ophthalmology) Physician
  • Greenfield, WI
  • NPI 1780671677
  Authorized official Same address or phone
• Hart Beaman Moss, M.D.

  • Cornea and External Diseases Specialist Physician
  • Greenfield, WI
  • NPI 1437393675

  Ophthalmology

  NPD

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1689719437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 S PACKARD AVE",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531103028",
            "telephone_number": "414-294-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 S 108TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302557",
            "telephone_number": "414-425-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMOLOGY ASSOCIATES S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "OWNER PARTNER",
        "authorized_official_telephone_number": "414-294-4660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CO1849",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32758700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael R Nicholson, CSAC CSIT
• Mitchel Olson, DPT
• Paige Olson, DC
• Lori Jean Olszewski, MS
• Debra J Onsager, ACUPUNCTURIST
• Options for Community Growth, Inc.
• Orthodontic Experts of Wisconsin, LLC
• Jodi Marie Osborne, D.C.
• Gabriela Palomino McComb, LCSW
• Anne Parady

• Ophthalmology Physician in Hales Corners, WI
• Providers in Hales Corners, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.