Patrick Jode Samels, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2517 Issued in WI

Practice address

2330 Oneida St
Suite 106
Green Bay, WI 54304

Phone

(920) 496-9699

Fax

(920) 496-1540

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Eyes LTD.Group PAC ID 3274695267, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Modern Eyes LTD.

  • Optometrist
  • Green Bay, WI
  • NPI 1811132830
  Medicare reassignment Care Compare group NPD
• Oneida Nation

  • Clinic/Center
  • Oneida, WI
  • NPI 1740278308
  Medicare reassignment NPD

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1801954979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 ONEIDA ST",
            "address_2": "SUITE 106",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54304",
            "telephone_number": "920-496-9699",
            "fax_number": "920-496-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 ONEIDA ST",
            "address_2": "SUITE 106",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54304",
            "telephone_number": "920-496-9699",
            "fax_number": "920-496-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMELS",
        "first_name": "PATRICK",
        "middle_name": "JODE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2517",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Salvanz Enterprises Inc
• Salvanz Enterprises Inc
• Peggi Salzman
• Joy Ann Salzwedel, MSW, LCSW, CSAC
• Sam'S Club Optical
• Melanie Lynn Samonds
• Brooke Kathleen Sample, MS
• Sams East Inc
• San Luis Health Care LLC
• San Luis Medical & Rehab

• Optometrist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.