Individual provider Active NPI

Scott Dennis Barnes, MD

  • Ophthalmology Physician
  • Milwaukee, WI
National Provider Identifier
1902054406
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101243947 Issued in VA
Practice address
1723 E Grange Ave
Milwaukee, WI 53207-6135
Phone
(414) 944-8267
NPI assigned
Sep 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101243947 VA Primary
Ophthalmology Physician 207W00000X 141432 CA
Ophthalmology Physician 207W00000X 036.144416 IL
Ophthalmology Physician 207W00000X MD2020-0969 NM
Ophthalmology Physician 207W00000X ME102245 FL

Addresses

Primary practice location

1723 E Grange Ave
Milwaukee, WI 53207-6135

Mailing address

PO Box 1117
Lake Forest, CA 92609-1117

Other practice location 1

77 Healy Ave
Building 257
Joint Base Langley-Eustis, VA 23665-8719
Phone (757) 238-3887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
141432CAMDOphthalmology Physician
ME102245FLMDOphthalmology Physician
036.144416ILMDOphthalmology Physician
0101243947VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Ophthalmology Past Accepting new patients

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": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1902054406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1117",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926091117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 E GRANGE AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532076135",
            "telephone_number": "414-944-8267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Healy Ave",
            "address_2": "Building 257",
            "address_purpose": "LOCATION",
            "city": "Joint Base Langley-Eustis",
            "state": "VA",
            "postal_code": "236658719",
            "country_code": "US",
            "telephone_number": "757-238-3887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARNES",
        "first_name": "SCOTT",
        "middle_name": "DENNIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-09",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101243947",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "141432",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036.144416",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NM",
            "license": "MD2020-0969",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME102245",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.