Macie Brahm, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4007-35 Issued in WI

Practice address

1674 Old Schoolhouse Rd Ste 101
Oconomowoc, WI 53066-1396

Phone

(262) 567-2295

NPI assigned

Jun 10, 2024

Last updated

Jun 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

University of Missouri St Louis - School of Optometry, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Watertown Vision LLCGroup PAC ID 8123267325, 3 clinicians

Oconomowoc Vision Clinic, LLCGroup PAC ID 5092896340, 2 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oconomowoc Vision Clinic, LLC

  • Optometrist
  • Oconomowoc, WI
  • NPI 1376724377
  Medicare reassignment Care Compare group NPD
• Watertown Vision, LLC

  • Optometrist
  • Watertown, WI
  • NPI 1780935957
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1831931914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1674 OLD SCHOOLHOUSE RD STE 101",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530661396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1674 OLD SCHOOLHOUSE RD STE 101",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530661396",
            "telephone_number": "262-567-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAHM",
        "first_name": "MACIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "4007-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Marie Bolyard
• Stephanie Lynn Bondioli, RPH
• Brenda L. Boschek, M.D.
• Sherri Bourdo
• Rita Jean Brafford, LCSW, CADC-D
• Mary Jo Brennan
• Stephen Michael Brennan, MD
• Julius T. Breyer
• Brighter Futures Therapy LLC
• Katherine Marie Brockway, NP

• 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 Jun 10, 2024; 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.