Midline Vision Group LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MIDLINE VISION GROUP LLC

Practice address

412 3Rd St
Mosinee, WI 54455-1425

Phone

(715) 693-2400

Fax

(608) 467-4556

NPI assigned

Oct 31, 2011

Last updated

Jul 12, 2021By 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

Jeremy Goetsch, O.D.NPI 1467696526

Title

Ceo

Phone

(715) 693-2400

Specialties & licenses 1

Addresses

Other names 1

• Advanced Madison Eye Care LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Tax ID family

Midline Vision Group LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Midline Vision Group LLC

  • Optometrist
  • Antigo, WI
  • NPI 1689382079
  NPD tax ID
• Midline Vision Group, LLC

  • Optometrist
  • Brookfield, WI
  • NPI 1275248429
  NPD tax ID
• Midline Vision Group, LLC

  • Optometrist
  • Fitchburg, WI
  • NPI 1285343301
  NPD tax ID

Locations

Practitioners 5

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.

• Jeremy Michael Goetsch, O.D.

  • Optometrist
  • Mosinee, WI
  • NPI 1467696526
  Medicare reassignment Care Compare group Authorized official
• Jessica Braunel, OD

  • Optometrist
  • Mosinee, WI
  • NPI 1669056974
  Medicare reassignment Care Compare group
• Kathryn Joan Koslowski Parsons, OD

  • Optometrist
  • Fitchburg, WI
  • NPI 1831759166
  Medicare reassignment Care Compare group
• Jill Marie Germain, O.D.

  • Optometrist
  • Monona, WI
  • NPI 1932388394
  Medicare reassignment
• Chelci S Schade, OD

  • Optometrist
  • Dodgeville, WI
  • NPI 1720571698
  Medicare reassignment

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1699051052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N 3RD ST STE 402",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035455",
            "telephone_number": "608-239-1218",
            "fax_number": "608-467-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 3RD ST",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544551425",
            "telephone_number": "715-693-2400",
            "fax_number": "608-467-4556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6231 McKee Rd",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Fitchburg",
            "state": "WI",
            "postal_code": "537195163",
            "country_code": "US",
            "telephone_number": "608-273-2020",
            "fax_number": "608-234-4330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "714 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Antigo",
            "state": "WI",
            "postal_code": "544092044",
            "country_code": "US",
            "telephone_number": "715-623-7244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDLINE VISION GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-31",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "GOETSCH",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "715-693-2400",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Madison Eye Care LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Karen L McKenna, RN
• Metro Chiropractic Clinic, S.C.
• Mary Jane-Shnowske Metropulos, D.C.
• Diana R Michlig, RN
• James J Michna, D.D.S.
• Ryan L Miller, DC
• Mosinee Family Chiropractic SC
• Mosinee Family Dental LLC
• Mosinee Fire District (Mosinee Ambulance Service)
• Mosinee School District

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.