Individual provider Active NPI

Amber E Bartels, OD

  • Optometrist
  • Oconomowoc, WI
National Provider Identifier
1962651364
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3211-35 Issued in WI
Practice address
1280 N Summit Ave
Oconomowoc, WI 53066-4459
Phone
(262) 567-3214
Fax
(262) 567-2449
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT904 ME
Optometrist 152W00000X 3211-35 WI Primary

Addresses

Primary practice location

1280 N Summit Ave
Oconomowoc, WI 53066-4459

Mailing address

1280 N Summit Ave
Oconomowoc, WI 53066-4459
Phone (262) 567-3214

Other identifiers 3

IdentifierTypeStateIssuer
1962651364MedicaidWI
433096599MedicaidME
OPT904OtherMEMAINE LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120214000541 WI Practitioner - Optometry 0648332205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas K. Marsh, OdscGroup PAC ID 4284536368, 2 clinicians

Practice addresses (Care Compare)

1280 N Summit Ave
Oconomowoc, WI 53066-4459
Phone (262) 567-3214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OPT904MEMDOptometrist
3211-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nehs Family Vision Center, Inc. Optometrist CurrentSince Feb 27, 2014 Accepting new patients
Thomas K. Marsh, Odsc Optometrist CurrentSince Jan 4, 2012 Accepting new patients
Primary Eyecare Optometrist Past Accepting new patients

Locations

1280 N Summit Ave
Summit, WI 53066
Phone (262) 567-3214

100 Arcadian Ave
Waukesha, WI 53186
Phone (262) 542-3676

Organizations & group practices 3

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": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1962651364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 N SUMMIT AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664459",
            "telephone_number": "262-567-3214",
            "fax_number": "262-567-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 N SUMMIT AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664459",
            "telephone_number": "262-567-3214",
            "fax_number": "262-567-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTELS",
        "first_name": "AMBER",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT904",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3211-35",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962651364",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433096599",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE LICENSE",
            "identifier": "OPT904",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.