Berlin Family Eye Care SC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BERLIN FAMILY EYE CARE SC

Practice address

100B E. Main St
Princeton, WI 54968

Phone

(920) 295-3880

NPI assigned

Apr 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Micheal D Gerber, ODNPI 1669523791

Title

President

Phone

(920) 361-1696

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Berlin Family Eye Care SC

  • Optometrist
  • Berlin, WI
  • NPI 1720139850

  7810963808

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Berlin Family Eye Care SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Berlin Family Eye Care SC

  • Optometrist
  • Berlin, WI
  • NPI 1720139850
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Micheal Dean Gerber, OD

  • Optometrist
  • Berlin, WI
  • NPI 1669523791
  NPD Authorized official
• Tammi L Sawallish, OD

  • Optometrist
  • Berlin, WI
  • NPI 1225063514
  NPD
• David Earl Johanknecht, OD

  • Optometrist
  • Berlin, WI
  • NPI 1114078243
  NPD (past)

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1992925176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 228",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549230228",
            "telephone_number": "920-361-1696",
            "fax_number": "920-361-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100B E. MAIN ST",
            "city": "PRINCETON",
            "state": "WI",
            "postal_code": "54968",
            "telephone_number": "920-295-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERLIN FAMILY EYE CARE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "GERBER",
        "authorized_official_first_name": "MICHEAL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-361-1696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3845580",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angles of the Mind LLC
• Barbara Jean Bittinger, L.AC.
• Richard Stanley Chisick Jr., D.C.
• City of Princeton
• Michael Joseph Coppersmith, D.C.
• Joseph Cornejo, L.AC.

• Optometrist in Princeton, WI
• Providers in Princeton, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.