MR. BRUCE JOHN PELZEK (NPI# 1376799486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376799486 |
| Entity Type | Individual |
| Full Name | MR. BRUCE JOHN PELZEK |
| Credential | OPTICIAN |
| Practice Address |
215 W Cook St Portage WI 53901-2105 |
| Practice Telephone | 6087422020 |
| Mailing Telephone | 6087422020 |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2008-08-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | BLUE CROSS/BLUE SHIELD | 391626448100 | 01 |
| WI | VIPA | 932447 | 01 |
| Street Address |
215 W COOK ST |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-2105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104264233 | Diana Lynn Haertel | Technician/Technologist | 215 W Cook St, Portage, WI 53901-2105 | 2013-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053556340 | America's Best Contacts & Eyeglasses | Technician/Technologist | 6800 S Westnedge Ave Ste E, Portage, MI 49002-3557 | 2008-12-16 |
| 1306004627 | Christine Savoy | Technician/Technologist | N8545 Staufenbeil Rd, Portage, WI 53901-9759 | 2008-05-23 |
| 1932200896 | Sam's Club Optical | Technician/Technologist | 665 Mall Dr, Portage, MI 49024-2879 | 2006-09-25 |
| 1104264233 | Diana Lynn Haertel | Technician/Technologist | 215 W Cook St, Portage, WI 53901-2105 | 2013-06-11 |
| 1124101761 | Wal-mart Stores, Lp | Technician/Technologist | 8350 Shaver Rd, Portage, MI 49024-5441 | 2006-10-24 |
| 1376625293 | Wal-mart Stores East, Lp | Technician/Technologist | 6087 Us Highway 6, Portage, IN 46368-5046 | 2006-10-19 |
| 1043391964 | Wal-mart Stores East, Lp | Technician/Technologist | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336782986 | Penny S Zaworski | Technician/Technologist | 806 N Old World 3rd St, Milwaukee, WI 53203-1701 | 2019-10-25 |
| 1326518002 | Robert Bailen | Technician/Technologist | 207 2nd Ave W, Ashland, WI 54806-1605 | 2018-11-26 |
| 1972051373 | Sam's East, Inc. | Technician/Technologist | 8100 N 124th Street, Milwaukee, WI 53223 | 2016-09-14 |
| 1568835544 | Jolanda Burnett | Technician/Technologist | 1645 N Central Ave, Marshfield, WI 54449-1550 | 2015-11-12 |
| 1467865857 | America's Best Contacts & Eyeglasses | Technician/Technologist | 9074 N Green Bay Rd, Brown Deer, WI 53209-1205 | 2014-06-04 |
| 1376882613 | Design Vision, Inc. | Technician/Technologist | 8720 W North Ave, Wauwatosa, WI 53226-2724 | 2013-02-06 |
| 1518259407 | Faces Eyewear, Inc | Technician/Technologist | 10 E College Ave, Appleton, WI 54911-5756 | 2011-05-10 |
| 1598073108 | Wal-mart Stores East Lp | Technician/Technologist | W159 S6530 Moorland, Muskego, WI 53150 | 2010-09-16 |
| 1285953794 | America's Best Contacts & Eyeglasses | Technician/Technologist | 8661 S Howell Ave Ste 200, Oak Creek, WI 53154-2919 | 2010-05-24 |
| 1053553453 | Lisa Cuda Mccarron | Technician/Technologist | 5500 E Cheryl Pkwy, Suite 103, Fitchburg, WI 53711-5336 | 2009-03-31 |
| 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.