Individual provider Active NPI

Mary Kathryn Schroeder, OD

  • Optometrist
  • Kaukauna, WI
National Provider Identifier
1730602467
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3484 Issued in WI
Practice address
1 Bank Ave
Kaukauna, WI 54130-2581
Phone
(920) 766-2481
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3484 WI Primary

Addresses

Primary practice location

1 Bank Ave
Kaukauna, WI 54130-2581

Mailing address

1 Bank Ave
Kaukauna, WI 54130-2581
Phone (920) 766-2481

Other practice location 1

1301 E Northland Ave
Appleton, WI 54911-8582
Phone (920) 205-6365

Other practice location 2

2189 E Prairie Creek Dr
Neenah, WI 54956
Phone (920) 205-6365

Other names 1

  • Dr. Mary Kathryn Wroblewski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180227000432 WI Practitioner - Optometry 2264793611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kimberly Eye Clinic IncGroup PAC ID 5991760829, 2 clinicians

Practice addresses (Care Compare)

919 W Kennedy Ave
Suite a
Kimberly, WI 54136-2205
Phone (920) 733-0919

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3484WIMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Eyecare LLC Optometrist CurrentSince Dec 24, 2017 Accepting new patients
Kimberly Eye Clinic Inc Optometrist CurrentSince Sep 1, 2019 Accepting new patients
Valley Vision Clinic SC Optometrist Past Accepting new patients
Magiera Eyecare LLC Optometrist PastSince Dec 24, 2017 Accepting new patients

Locations

N1739 Lily of the Valley Dr
Ste 2
Greenville, WI 54942
Phone (920) 560-3937

1 Bank Ave
Kaukauna, WI 54130
Phone (920) 766-2481

1 Bank Ave
Ste B
Kaukauna, WI 54130
Phone (920) 766-2481

919 W Kennedy Ave
#A
Kimberly, WI 54136
Phone (920) 733-0919

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ocuco_greenvilleeyecare

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730602467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BANK AVE",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541302581",
            "telephone_number": "920-766-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BANK AVE",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541302581",
            "telephone_number": "920-766-2481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 E Northland Ave",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549118582",
            "country_code": "US",
            "telephone_number": "920-205-6365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2189 E Prairie Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "54956",
            "country_code": "US",
            "telephone_number": "920-205-6365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "WROBLEWSKI",
            "middle_name": "KATHRYN",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kaukauna, WI

Sources for this page

Verify at the official NPI Registry.