Individual provider Active NPI

Dave A. Ziegler, O.D.

  • Optometrist
  • New Berlin, WI
National Provider Identifier
1770557076
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1848 Issued in WI
Practice address
14151 W National Ave Ste 102
New Berlin, WI 53151-4528
Phone
(414) 541-2100
Fax
(414) 541-2377
NPI assigned
Feb 14, 2006
Last updated
Apr 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 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 1848 WI Primary

Addresses

Primary practice location

14151 W National Ave Ste 102
New Berlin, WI 53151-4528

Mailing address

14151 W National Ave Ste 102
New Berlin, WI 53151-4528
Phone (414) 541-2100

Other identifiers 1

IdentifierTypeStateIssuer
38521200MedicaidWI

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
I20060928000279 WI Practitioner - Optometry 2668477589 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1848WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Wisconsin, LLC Optometrist CurrentSince Jun 17, 2019 Accepting new patients
Myeyedr Optometry of Wisconsin, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Wisconsin, LLC Optometrist CurrentSince Jun 17, 2019 Accepting new patients

Locations

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

2305 30th Ave
Kenosha, WI 53144
Phone (262) 597-2020

14151 W National Ave
New Berlin, WI 53151
Phone (414) 541-2100

14151 W National Ave
Ste 102
New Berlin, WI 53151
Phone (414) 541-2100

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1770557076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14151 W NATIONAL AVE STE 102",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514528",
            "telephone_number": "414-541-2100",
            "fax_number": "414-541-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14151 W NATIONAL AVE STE 102",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514528",
            "telephone_number": "414-541-2100",
            "fax_number": "414-541-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEGLER",
        "first_name": "DAVE",
        "middle_name": "A.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38521200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

Verify at the official NPI Registry.