Mark S Spankowski, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1834-035 Issued in WI

Practice address

608 E. Summit Ave.
Oconomowoc, WI 53066

Phone

(262) 567-6565

Fax

(262) 567-8214

NPI assigned

Mar 15, 2007

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Family Eye Care of Lake Geneva, S.C.

  • Optometrist
  • Lake Geneva, WI
  • NPI 1144463571
  Medicare reassignment NPD
• Ladd F. Koresch O.D., S.C.

  • Optometrist
  • Lake Geneva, WI
  • NPI 1104029867
  NPD (past)
• Summit Eye Clinic SC

  • Optometrist
  • Oconomowoc, WI
  • NPI 1679520845
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831223338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 E. SUMMIT AVE.",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "53066",
            "telephone_number": "262-567-6565",
            "fax_number": "262-567-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 E. SUMMIT AVE.",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "53066",
            "telephone_number": "262-567-6565",
            "fax_number": "262-567-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANKOWSKI",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1834-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38517900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Smith, LPC-IT
• Megan Sobotik
• Louis John Soefker Jr., RPH
• Solidaritus Health Wisconsin SC
• South Street Clinic LLC
• Speechworks LLC
• Carrey Spencer, RDH
• Samantha Sporleder, OTA
• Ana Sprecher
• Jeffrey W Stache

• Optometrist in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.