Northeast Wisconsin Vision Center, LTD
Organization Active NPI Optician · Oshkosh, WI
NPI 1790905073 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1790905073
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optician 156FX1800X
- Legal business name
- NORTHEAST WISCONSIN VISION CENTER, LTD
- Practice address
- 1885 West Pointe Dr
Oshkosh, WI 54902-4174 - Phone
- (920) 232-6550
- Fax
- (920) 232-6552
- NPI assigned
- Apr 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Stephen J Merfeld, M.D.
- Title
- President
- Phone
- (920) 232-6550
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 2
Practitioners 8
-
Jessica Kulick, O.D.
-
Eric M Larson, M.D.
-
Paul Hubert Payant, O.D.
-
Meisha Raven, D.O.
-
Stephen J Merfeld, M.D.
-
Wesley Meyer, O.D.
-
Jill A Anderson, O.D.
-
Andrew M Josephs, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930003280 | WI | DME Supplier - Physician - Ophthalmology |
2961456512 | Practice locations: Oshkosh, WI |
National Provider Directory
- Tax ID family
- Northeast Wisconsin Vision Center LTD
Locations
191 Memorial Dr
Berlin, WI 54923
Phone (920) 223-5580
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician |
156FX1800X | Yes |
Addresses
Primary practice location
1885 West Pointe Dr
Oshkosh, WI 54902-4174
Mailing address
PO Box 2723
Oshkosh, WI 54903-2723
Phone (920) 232-6550
Other providers in Oshkosh, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.