OPHTHALMOLOGY ASSOCIATES S C (NPI# 1063557890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063557890 |
| Entity Type | Organization |
| Organization Name | OPHTHALMOLOGY ASSOCIATES S C |
| Practice Address |
6020 S Packard Ave Cudahy WI 53110-3028 |
| Practice Telephone | 4142944660 |
| Mailing Telephone | 4142944660 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-10-25 |
| Authorized Official Name | DR. GLENN E GRAVES (PARTNER OWNER) |
| Authorized Official Telephone | 4142944660 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32758700 | 05 | |
| RAILROAD MEDICARE | CO1849 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720543614 | Ophthalmology Associates S C | Optometrist | 4600 W Loomis Rd Ste 310, Greenfield, WI 53220-4858 | 2019-02-05 |
| 1689719437 | Ophthalmology Associates S C | Optometrist | 6080 S 108th St, Hales Corners, WI 53130-2557 | 2007-02-20 |
| 1255476099 | Ophthalmology Associates S C | Optometrist | 2500 W Layton Ave, Suite 110, Milwaukee, WI 53221-5420 | 2007-02-20 |
| 1730224585 | Ophthalmology Associates S C | Optometrist | 14555 W National Ave, New Berlin, WI 53151-4494 | 2007-02-20 |
| Street Address |
6020 S PACKARD AVE |
| City | CUDAHY |
| State | WI |
| Zip Code | 53110-3028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912994807 | Edward W. Waldeck | Ophthalmology | 6020 S Packard Ave, Cudahy, WI 53110-3028 | 2005-10-05 |
| 1891236089 | Qian Yang | Optometrist | 6020 S Packard Ave, Cudahy, WI 53110-3028 | 2017-03-20 |
| 1154638591 | Jaclyn E. Garlich | Optometrist | 6020 S Packard Ave, Lower, Cudahy, WI 53110-3028 | 2010-09-07 |
| 1790998581 | Ophthalmology Associates | Durable Medical Equipment & Medical Supplies | 6020 S Packard Ave, Cudahy, WI 53110-3028 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164059150 | Access Mobility Vans, Inc. | Durable Medical Equipment & Medical Supplies | 1995 E. Norse Ave., Cudahy, WI 53110 | 2020-03-27 |
| 1497191357 | Kristel Roebbeke | Occupational Therapist | 4157 W College Ave, Milwaukee, WI 53110 | 2013-05-20 |
| 1568684058 | City of Cudahy | Case Management | 5050 South Lake Drive, Cudahy, WI 53110 | 2007-05-03 |
| 1104854363 | Mathew George Mathai | Internal Medicine | 5900 S. Lake Dr., Cudahy, WI 53110 | 2006-06-28 |
| 1174917199 | Alyssa Kaleta | Internal Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2015-03-27 |
| 1740546829 | Fatima Ali | Family Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2012-04-03 |
| 1609003508 | Elizabeth A Vissat | Podiatrist | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2009-06-18 |
| 1366616864 | Miguel A Aguilera | Anesthesiology | 5900 S Lake Dr, Cudahy, WI 53110 | 2008-04-15 |
| 1235355983 | Aurora Health Care Metro, Inc. | Clinic/Center | 5900 S Lake Drive, Cudahy, WI 53110 | 2007-04-18 |
| 1114005618 | Manila Sodhi | Internal Medicine | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2006-11-01 |
| Find all providers in zip 53110 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912994807 | Edward W. Waldeck | Ophthalmology | 6020 S Packard Ave, Cudahy, WI 53110-3028 | 2005-10-05 |
| 1851497911 | Casimiro Gonzalez | Ophthalmology | 4566 Florence Ave, #3, Cudahy, CA 90201-4345 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669093308 | Eye Physicians and Surgeons Sc | Ophthalmology | 675 W State Street, Burlington, WI 53105-2152 | 2020-05-05 |
| 1992350375 | Summit Eye Care of Wisconsin Sc | Ophthalmology | 10425 W North Ave Ste 245, Wauwatosa, WI 53226-2416 | 2019-08-02 |
| 1912566597 | William Alden Blank | Ophthalmology | W5843 Vista Dr, La Crosse, WI 54601-7120 | 2019-06-07 |
| 1962974485 | Southwest Health Center, Inc. | Ophthalmology | 1509 Ihm St, Lancaster, WI 53813-9458 | 2018-12-21 |
| 1477083194 | Maxwell Joseph Wingelaar | Ophthalmology | Uw Health University Hospital, Madison, WI 53792 | 2017-06-14 |
| 1770967572 | Baycare Clinic LLP | Ophthalmology | 1603 Washington Street, Two Rivers, WI 54241 | 2015-07-13 |
| 1114315587 | Eye Clinic of Wisconsin, Sc | Ophthalmology | 841 Goodnow Ave, Suite 103, Wisconsin Rapids, WI 54494-0315 | 2015-01-07 |
| 1164824231 | Arthur Francis Garcia | Ophthalmology | 7025 Cedar Creek Rd, Cedarburg, WI 53012-9778 | 2014-09-20 |
| 1962820027 | Jennifer Ciske Larson | Ophthalmology | 2349 Deming Way Deming Way Eye Clinic, Middleton, WI 53562 | 2014-04-04 |
| 1003233255 | Kenneth Weinlander | Ophthalmology | 740 N Plankinton Ave Ste 836, Milwaukee, WI 53203-2403 | 2014-03-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.