NPIMap

Individual provider Active NPI

Philip Michael Smith, M.D.

  • Ophthalmology Physician
  • Minocqua, WI
National Provider Identifier
1952351876
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
53051 Issued in WI
Practice address
9576 Hwy 70
Minocqua, WI 54548-9067
Phone
(715) 387-5236
NPI assigned
May 11, 2006
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X C134021 CA
Ophthalmology Physician 207W00000X 53051 WI Primary

Addresses

Primary practice location

9576 Hwy 70
Minocqua, WI 54548-9067

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5702

Other practice location 1

3211 Fortune Ct
Suite A
Auburn, CA 95602-9245
Phone (530) 885-6241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090716000450 WI Practitioner - Ophthalmology 2567475890 Reassigns benefits to 10 organizations
I20150519002840 CA Practitioner - Ophthalmology 2567475890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Texas Tech University Health Science Center School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Eye AssociatesGroup PAC ID 5395633580, 25 clinicians

Practice addresses (Care Compare)

1301 E Northland Ave
Suite a
Appleton, WI 54911-8582
Phone (920) 734-8714

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery237

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C134021CAMDOphthalmology Physician
53051WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 13, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 13, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 26, 2020 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 13, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince Jan 6, 2021 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 26, 2020 Accepting new patients
Glenn Medical Center, LLC Current Accepting new patients
Valley Eye Associates Ophthalmology CurrentSince Mar 1, 2024 Accepting new patients
Sierra Eyecare Associates CurrentSince Apr 10, 2015 Accepting new patients
Flambeau Hospital Inc CurrentSince Dec 13, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 13, 2023 Accepting new patients
Park Place Optical, LTD Past Accepting new patients

Locations

817 Court St
Ste 10
Jackson, CA 95642
Phone (209) 223-2020

1133 W Sycamore St
Willows, CA 95988
Phone (530) 934-1800

1301 E Northland Ave
Ste A
Appleton, WI 54911
Phone 9207348714 ext. 116

21 Park Pl
Appleton, WI 54914
Phone (920) 739-4361

4648 W Spencer St
Appleton, WI 54914
Phone (920) 731-7557

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1543 Park Pl
Ste 400
Green Bay, WI 54304
Phone (920) 497-0100

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

9576 State Highway 70
Minocqua, WI 54548
Phone (715) 358-1000

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1952351876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9576 HWY 70",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489067",
            "telephone_number": "715-387-5236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3211 Fortune Ct",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "CA",
            "postal_code": "956029245",
            "country_code": "US",
            "telephone_number": "530-885-6241",
            "fax_number": "530-885-0144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PHILIP",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C134021",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "53051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minocqua, WI

Sources for this page

Verify at the official NPI Registry.