Glenn E. Graves, M.D.

Primary specialty

Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X

License

27890-020 Issued in WI

Practice address

4600 W Loomis Rd Ste 310
Greenfield, WI 53220-4858

Phone

(414) 281-0963

Fax

(414) 281-0959

NPI assigned

Oct 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ophthalmology Associates S CGroup PAC ID 6204723869, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

Merit-based Incentive Payment System (MIPS)

Final score

92.27 of 100Reported as group

Quality

100

Improvement activities

40

Cost

74.23

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ggraves@oasc.intellechartdirect.net

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.

• Ophthalmology Associates S C

  • Ophthalmology Physician
  • Cudahy, WI
  • NPI 1063557890
  Medicare reassignment Care Compare group NPD Authorized official
• Ophthalmology Associates S C

  • Ophthalmology Physician
  • Milwaukee, WI
  • NPI 1255476099
  NPD (past) Authorized official
• Ophthalmology Associates S C

  • Ophthalmology Physician
  • Greenfield, WI
  • NPI 1720543614
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aurora Health Care Metro, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cudahy, WI
  • NPI 1235355983

  Hospital

  Care Compare affiliation
• Aurora Health Care Metro, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1861447179
  Care Compare affiliation

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1780671677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 S PACKARD AVE",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531103028",
            "telephone_number": "414-294-4660",
            "fax_number": "414-281-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 W LOOMIS RD STE 310",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204858",
            "telephone_number": "414-281-0963",
            "fax_number": "414-281-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "GLENN",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "27890-020",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "WI",
            "license": "27890-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "180020621",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "391484998011",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "391484998C",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMECARE",
            "identifier": "0800065",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "391484998",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31485900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aryn Lea Goodwin, DNP, FNP-BC, APNP
• Robert Gould, MD
• Kalana L Graham, LCSW
• Erika Grahovac
• Lindsey Marie Gram, RN, BSN
• Kimberly Gray, FNP-BC
• Greater Milwaukee Oral Surgery, LLC
• Greater Milwaukee Otolaryngology LLC
• Fauzia Nimako Green
• Greenfield Optimal Dental Care LLC

• Glaucoma Specialist (Ophthalmology) Physician in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Glaucoma Specialist (Ophthalmology) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.