Eye Centers of Racine and Kenosha LTD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

EYE CENTERS OF RACINE AND KENOSHA LTD

Practice address

13200 Globe Dr Ste 216
Mt Pleasant, WI 53177-1605

Phone

(262) 637-0500

Fax

(262) 635-8027

NPI assigned

Jul 18, 2006

Organization subpart

No

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

Authorized official

Name

Melissa Gottfredsen

Title

Practice Administrator

Phone

(262) 898-5673

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 2

• Eye Center of Racine LTD Former legal business name
• The Eye Centers of Racine and Kenosha Other name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeff Banas, OD

  • Optometrist
  • Mount Pleasant, WI
  • NPI 1619328606
  Medicare reassignment Care Compare group NPD
• Demetra M Danos, OD

  • Optometrist
  • Kenosha, WI
  • NPI 1437995842
  Medicare reassignment Care Compare group NPD
• Eric Duresa, OD

  • Optometrist
  • Mount Pleasant, WI
  • NPI 1285319889
  Medicare reassignment Care Compare group NPD
• Jeffna Elavumkal, OD

  • Optometrist
  • Kenosha, WI
  • NPI 1699560169
  Medicare reassignment Care Compare group NPD
• Radha Krishna Sanka, M.D.

  • Ophthalmology Physician
  • Mount Pleasant, WI
  • NPI 1508042060
  Medicare reassignment Care Compare group NPD
• Inder Paul Singh

  • Ophthalmology Physician
  • Racine, WI
  • NPI 1063430023
  Medicare reassignment Care Compare group NPD
• Stephen J Pruett

  • Optometrist
  • Racine, WI
  • NPI 1427070259
  Medicare reassignment NPD
• Jessica G Schiffbauer, OD

  • Optometrist
  • Kenosha, WI
  • NPI 1659723328
  Medicare reassignment NPD

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1710905781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805B SPRING ST",
            "address_2": "SUITE 140",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051641",
            "telephone_number": "262-637-0500",
            "fax_number": "262-635-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13200 GLOBE DR STE 216",
            "city": "MT PLEASANT",
            "state": "WI",
            "postal_code": "531771605",
            "telephone_number": "262-637-0500",
            "fax_number": "262-635-8027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3805B Spring St Ste 140",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "WI",
            "postal_code": "534051642",
            "country_code": "US",
            "telephone_number": "262-637-8835",
            "fax_number": "262-635-8027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9916 75th St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531427583",
            "country_code": "US",
            "telephone_number": "262-637-0500",
            "fax_number": "262-635-8027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EYE CENTERS OF RACINE AND KENOSHA LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "GOTTFREDSEN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "262-898-5673"
    },
    "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100202317",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NGS ADMINISTAR",
            "identifier": "0631860001",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38713800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Center of Racine LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Eye Center of Racine LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "The Eye Centers of Racine and Kenosha",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mihail Cristian Epure, MD
• Shelly R Erickson, SAC
• Laurel L Evans, APNP
• Extend Physical Therapy and Wellness
• Eye Centers of Racine and Kenosha LTD
• Eye Clinic of Racine, LTD.
• Denise L Falaschi, LPC
• Family Impact, Inc
• Frank C Fantazzi, PT DPT
• Farah Faridi

• Ophthalmology Physician in Mt Pleasant, WI
• Providers in Mt Pleasant, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.