Eugene John Eldridge, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

25921 Issued in WI

Practice address

1400 75TH St
Suite 3
Kenosha, WI 53143-1544

Phone

(262) 652-9500

Fax

(262) 652-0760

NPI assigned

Oct 26, 2006

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Northwestern University Feinberg Medical School, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• E John Eldridge MD SC

  • Ophthalmology Physician
  • Kenosha, WI
  • NPI 1073610242
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932284296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 75TH ST",
            "address_2": "SUITE 3",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531431544",
            "telephone_number": "262-652-9500",
            "fax_number": "262-652-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 75TH ST",
            "address_2": "SUITE 3",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531431544",
            "telephone_number": "262-652-9500",
            "fax_number": "262-652-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRIDGE",
        "first_name": "EUGENE",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "25921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31384000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Ehnert-Horbinski, APSW
• Nicole Eide
• Nancy Sue Eisner
• Jeffna Elavumkal, OD
• Nichole M Elcano, DDS
• Mary Patricia Eldridge, M.D.
• Arneetrice Ellerman, COMS
• Erin Ellsworth, APNP
• Joshua Knute Elson, MD, MPH
• Christopher Aaron Elwell, DPT

• Ophthalmology Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Ophthalmology Physician 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.
• 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.