Individual provider Active NPI

Michael J Bardenwerper, O.D.

  • Optometrist
  • West Bend, WI
National Provider Identifier
1801150552
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3257-35 Issued in WI
Practice address
1116 N Main St
West Bend, WI 53090-1923
Phone
(262) 247-2343
Fax
(262) 247-2340
NPI assigned
Jun 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3257-35 WI Primary

Addresses

Primary practice location

1116 N Main St
West Bend, WI 53090-1923

Mailing address

1116 N Main St
West Bend, WI 53090-1923
Phone (262) 247-2343

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
I20120920000536 WI Practitioner - Optometry 0345498051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Focus Eyecare LLCGroup PAC ID 4981910999, 3 clinicians

Practice addresses (Care Compare)

1116 N Main St
West Bend, WI 53090-1923
Phone (262) 247-2343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3257-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Focus Eyecare LLC Optometrist CurrentSince Aug 3, 2015 Accepting new patients

Locations

1116 N Main St
West Bend, WI 53090
Phone (262) 247-2343

Organizations & group practices 1

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1801150552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 N MAIN ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530901923",
            "telephone_number": "262-247-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 N MAIN ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530901923",
            "telephone_number": "262-247-2343",
            "fax_number": "262-247-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDENWERPER",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2026-02-12",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3257-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

Verify at the official NPI Registry.