Eye Wisconsin Llc is a medicare enrolled "Optometrist" provider in Waterford, Wisconsin. Their current practice location is
401 N Milwaukee St Ste 3, Waterford, Wisconsin. You can reach out to their office (for appointments etc.) via phone at
(262) 534-9100.
Eye Wisconsin Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Eye Wisconsin Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1487392585.
Healthcare Provider's Profile
| Full Name | Eye Wisconsin Llc |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 401 N Milwaukee St Ste 3, Waterford, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1487392585
- Provider Enumeration Date: 05/27/2022
- Last Update Date: 05/27/2022
Medicare PECOS Information:
- PECOS PAC ID: 5395120018
- Enrollment ID: O20220916000987
Medical Identifiers
Medical identifiers for Eye Wisconsin Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1487392585 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Eye Wisconsin Llc acts as a billing entity for following providers:
| Provider Name | Bradley Grant |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1386836518
PECOS PAC ID: 2163598939
Enrollment ID: I20220916001171 |
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| Provider Name | Zachary L Thomason |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1285309591
PECOS PAC ID: 2860898103
Enrollment ID: I20220921003482 |
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| Provider Name | Lai Jiang |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1790479996
PECOS PAC ID: 4385004639
Enrollment ID: I20230718002179 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Eye Wisconsin Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Eye Wisconsin Llc
1090 Bucks Pond Rd,
Monticello, IL 61856-8058
Ph: (901) 496-9129 | Eye Wisconsin Llc
401 N Milwaukee St Ste 3,
Waterford, WI 53185-4493
Ph: (262) 534-9100 |
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