Active NPI
Myron E. Praeger, O.D.
- Optometrist
- Milwaukee, WI
National Provider Identifier
1942230933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1690
- Practice address
- 3003 W Good Hope Rd
Milwaukee, WI 53209-2042 - Phone
- (414) 352-3100
- Fax
- (414) 247-4597
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1690 | WI | Primary |
Addresses
Primary practice location
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Mailing address
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00450902 | Other | WI | RR MEDICARE |
| 38509700 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mpraeger648@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1690 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Healthcare SC | 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.
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1154371847
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1942230933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3003 W GOOD HOPE RD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532092042",
"telephone_number": "414-352-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3003 W GOOD HOPE RD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532092042",
"telephone_number": "414-352-3100",
"fax_number": "414-247-4597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRAEGER",
"first_name": "MYRON",
"middle_name": "E.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-04",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "1690",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00450902",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38509700",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mpraeger648@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "3003 W Good Hope Rd",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532092042",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "3003 W Good Hope Rd",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532092042",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Dec 1, 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.