Christina Marie Petrou, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2387-035 Issued in WI

Practice address

7040 N Port Washington Rd
Suite 420
Glendale, WI 53217-3885

Phone

(414) 247-2020

NPI assigned

Jun 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Dr. Christina Marie Petrou-Haefs Professional name

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, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Petrou-Haefs Eyecare, LLC

  • Clinic/Center
  • Glendale, WI
  • NPI 1891068599
  Medicare reassignment NPD Authorized official
• Pewaukee Vision SC

  • Optometrist
  • Waukesha, WI
  • NPI 1780053595
  NPD

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1912945338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 E GOODRICH LN",
            "city": "FOX POINT",
            "state": "WI",
            "postal_code": "532172951",
            "telephone_number": "414-839-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7040 N PORT WASHINGTON RD",
            "address_2": "SUITE 420",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532173885",
            "telephone_number": "414-247-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROU",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WI",
            "license": "2387",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "WI",
            "license": "2387-035",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2387-035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "2718",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38575400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "PETROU-HAEFS",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kristen Paxson
• Larissa Lynn Perry, LMT
• Personal Care Solutions LLC
• Holly Marie Pete, C.O.T.A.
• Petrou-Haefs Eyecare, LLC
• Physiological Health Sanctuary LLC
• Pin Point Transportation LLC
• Kyle James Piscitello, PHARMD
• Frances B Pitt, MSW
• David C Poehlmann, CSAC, LCSW, ICS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.