Eye Associates of Green Bay, SC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

EYE ASSOCIATES OF GREEN BAY, SC

Practice address

2020 Riverside Dr Ste 201
Green Bay, WI 54301-2300

Phone

(920) 965-7000

Fax

(920) 965-4701

NPI assigned

Jul 16, 2007

Last updated

May 29, 2020By 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

Sally Jilot

Title

Administrator

Phone

(920) 965-4800

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

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.

• Anatol J Stankevych, M.D.

  • Ophthalmology Physician
  • Green Bay, WI
  • NPI 1245375948
  Medicare reassignment Care Compare group NPD
• Natalie A Stankevych, O.D.

  • Optometrist
  • Green Bay, WI
  • NPI 1770628489
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590710400000",
    "number": "1699974980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 RIVERSIDE DR STE 201",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012300",
            "telephone_number": "920-965-7000",
            "fax_number": "920-965-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 RIVERSIDE DR STE 201",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012300",
            "telephone_number": "920-965-7000",
            "fax_number": "920-965-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF GREEN BAY, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A",
        "authorized_official_last_name": "JILOT",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "920-965-4800"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "000007100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WMAP GROUP",
            "identifier": "32899700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINASTAR FEDERAL REGION",
            "identifier": "4334090001",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GROUP",
            "identifier": "CJ2796",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evergreen Family Focus, LLC
• Brooke R Evers, BCBA
• Judith H Everson, APNP
• Rudolph Francis Evonich III, M.D.
• Judy A Exl, MSW
• Eye Care for You, SC
• Eye Care Professionals Inc
• Eye See, LLC
• Meghan Callaghan Eytcheson, CCC-SLP
• Chinenye Vivian Ezembamalu, NP

• Ophthalmology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; 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.