Individual provider Active NPI

Erik R Bjork, O.D

  • Optometrist
  • Oconomowoc, WI
National Provider Identifier
1962453589
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009823 Issued in IL
Practice address
105 E Wisconsin Ave
#206
Oconomowoc, WI 53066-3058
Phone
(262) 354-8179
Fax
(262) 354-8441
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009823 IL Primary
Optometrist 152W00000X 3203-35 WI

Addresses

Primary practice location

105 E Wisconsin Ave
#206
Oconomowoc, WI 53066-3058

Mailing address

105 E Wisconsin Ave
#206
Oconomowoc, WI 53066-3058
Phone (262) 354-8179

Other identifiers 4

IdentifierTypeStateIssuer
0001604768OtherILBLUE CROSS BLUE SHIELD
046009823MedicaidIL
100035271MedicaidWI
P00312305OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110413000970 WI Practitioner - Optometry 2567420839 Reassigns benefits to 2 organizations
I20240620003010 IN Practitioner - Optometry 2567420839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009823ILMDOptometrist
3203-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Watertown Vision, LLC Optometrist CurrentSince Mar 10, 2013 Accepting new patients
Jeffrey L. Morer, OD, PC Optometrist CurrentSince May 19, 2022 Accepting new patients
Jeffrey L. Morer, OD, PC Optometrist CurrentSince May 12, 2024 Accepting new patients
Jeffrey L. Morer, OD, PC Optometrist CurrentSince May 19, 2022 Accepting new patients
Oconomowoc Vision Clinic, LLC Optometrist PastSince May 1, 2015 Accepting new patients

Locations

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

1640 S Church St
Watertown, WI 53094
Phone (262) 705-6958

9047 W Greenfield Ave
West Allis, WI 53214
Phone (414) 453-9290

Organizations & group practices 5

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1962453589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E WISCONSIN AVE",
            "address_2": "#206",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663058",
            "telephone_number": "262-354-8179",
            "fax_number": "262-354-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E WISCONSIN AVE",
            "address_2": "#206",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663058",
            "telephone_number": "262-354-8179",
            "fax_number": "262-354-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJORK",
        "first_name": "ERIK",
        "middle_name": "R",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009823",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3203-35",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001604768",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009823",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100035271",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00312305",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.