Individual provider Active NPI

Wanda M Martinez Navarro, M.D., PH.D.

  • Ophthalmology Physician
  • Milwaukee, WI
National Provider Identifier
1821053109
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
48682 Issued in WI
Practice address
925 North 87TH Street
The Eye Institute
Milwaukee, WI 53226
Phone
(414) 955-2020
Fax
(414) 955-6300
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 48682 WI Primary

Addresses

Primary practice location

925 North 87TH Street
The Eye Institute
Milwaukee, WI 53226

Mailing address

925 North 87TH Street
The Eye Institute
Milwaukee, WI 53226
Phone (414) 955-2020

Other identifiers 1

IdentifierTypeStateIssuer
1821053109MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
48682WIMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1821053109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 NORTH 87TH STREET",
            "address_2": "THE EYE INSTITUTE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-955-2020",
            "fax_number": "414-955-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 NORTH 87TH STREET",
            "address_2": "THE EYE INSTITUTE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-955-2020",
            "fax_number": "414-955-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ NAVARRO",
        "first_name": "WANDA",
        "middle_name": "M",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "48682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821053109",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.