| Myeyedr Optometry Of Wisconsin, Llc | |
|
2305 30th Ave, Kenosha, WI 53144-1411 | |
| (262) 597-2020 | |
| (262) 597-5452 |
| Full Name | Myeyedr Optometry Of Wisconsin, Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2305 30th Ave, Kenosha, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164992996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Eric Paul Pedersen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992793806 PECOS PAC ID: 3274426630 Enrollment ID: I20040209000024 |
| Provider Name | Joel D Baisden |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992867220 PECOS PAC ID: 5193718666 Enrollment ID: I20040408000568 |
| Provider Name | John G Knuth |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396715173 PECOS PAC ID: 2769411206 Enrollment ID: I20050805000050 |
| Provider Name | Renee B Haefs |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609883990 PECOS PAC ID: 5092745836 Enrollment ID: I20050822000240 |
| Provider Name | Jeffrey R Thomas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1487685988 PECOS PAC ID: 9436182417 Enrollment ID: I20050913000052 |
| Provider Name | Michael D Main |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386687333 PECOS PAC ID: 1456384809 Enrollment ID: I20050916000490 |
| Provider Name | Gregory T Pierangeli |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982787552 PECOS PAC ID: 9234126269 Enrollment ID: I20050930000551 |
| Provider Name | Cara A Ystad |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730239625 PECOS PAC ID: 4284653353 Enrollment ID: I20051117000527 |
| Provider Name | Shane A Solberg |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285624080 PECOS PAC ID: 4082622774 Enrollment ID: I20060322000101 |
| Provider Name | Dave A Ziegler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770557076 PECOS PAC ID: 2668477589 Enrollment ID: I20060928000279 |
| Provider Name | H Chapman Leffingwell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548234123 PECOS PAC ID: 5294730115 Enrollment ID: I20060928000284 |
| Provider Name | Donna M Brunello |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821021445 PECOS PAC ID: 7517965536 Enrollment ID: I20061129000130 |
| Provider Name | Kevin A Harry |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821078189 PECOS PAC ID: 9537262951 Enrollment ID: I20070305000689 |
| Provider Name | Richard W Miller |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235204876 PECOS PAC ID: 2163526427 Enrollment ID: I20070327000482 |
| Provider Name | Kristen K Dorman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609833110 PECOS PAC ID: 9638274814 Enrollment ID: I20070417000305 |
| Provider Name | Benjamin R Clark |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063612497 PECOS PAC ID: 8729172739 Enrollment ID: I20070921000348 |
| Provider Name | Dean A Rosenberg |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679558282 PECOS PAC ID: 6103911821 Enrollment ID: I20070926000742 |
| Provider Name | Sheryl Lindman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285628172 PECOS PAC ID: 3678644770 Enrollment ID: I20080617000655 |
| Provider Name | Jennifer L Pileski Perona |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194866624 PECOS PAC ID: 5395819528 Enrollment ID: I20080805000799 |
| Provider Name | Jennifer Gipp |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154520666 PECOS PAC ID: 8729189899 Enrollment ID: I20090728000141 |
| Provider Name | Eric L Knight |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841294618 PECOS PAC ID: 8022009034 Enrollment ID: I20100618000834 |
| Provider Name | Michelle H Pedersen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912990425 PECOS PAC ID: 9931231602 Enrollment ID: I20100715000307 |
| Provider Name | Randall J Paye |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508903766 PECOS PAC ID: 1153437918 Enrollment ID: I20110114000435 |
| Provider Name | Lynn Carli |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184694861 PECOS PAC ID: 2365558681 Enrollment ID: I20110121000101 |
| Provider Name | Cynthia Malvitz Overly |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457498602 PECOS PAC ID: 0143336024 Enrollment ID: I20110217000536 |
| Provider Name | Stephen M Waclawski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295832392 PECOS PAC ID: 4587767090 Enrollment ID: I20110221000984 |
| Provider Name | Maria M Steck |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306966379 PECOS PAC ID: 6507807526 Enrollment ID: I20110722000401 |
| Provider Name | Carol A Main |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114910536 PECOS PAC ID: 8527092303 Enrollment ID: I20130808000786 |
| Provider Name | Kristen E Ziegler |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1275940603 PECOS PAC ID: 9537470828 Enrollment ID: I20150611003422 |
| Provider Name | Jeremy P Kemmerling |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225414733 PECOS PAC ID: 3577879634 Enrollment ID: I20150903001584 |
| Provider Name | Michael S Waclawski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619383700 PECOS PAC ID: 5597986315 Enrollment ID: I20180301000194 |
| Provider Name | Jordyn Grace Matuschka |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851882187 PECOS PAC ID: 4385999424 Enrollment ID: I20180614000089 |
| Provider Name | Hussam Saras |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508341470 PECOS PAC ID: 1254685779 Enrollment ID: I20181119001804 |
| Provider Name | Matthew Francis Byers |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558845081 PECOS PAC ID: 6507110814 Enrollment ID: I20190201000601 |
| Provider Name | Katlyn Marie Potts |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457730137 PECOS PAC ID: 1254647738 Enrollment ID: I20190425001036 |
| Provider Name | Alexandra Brandt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205361359 PECOS PAC ID: 6507191087 Enrollment ID: I20190708000349 |
| Provider Name | Kirsten Albrecht |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1952369308 PECOS PAC ID: 4486710787 Enrollment ID: I20210420000327 |
| Provider Name | Stephanie D'orazio-brafman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811372279 PECOS PAC ID: 6406156678 Enrollment ID: I20210630002757 |
| Provider Name | Pamela Marie Marzec |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134472996 PECOS PAC ID: 5092958942 Enrollment ID: I20210907000767 |
| Provider Name | Deanna Ippolito |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225683121 PECOS PAC ID: 8426388257 Enrollment ID: I20210907003567 |
| Provider Name | Jacqueline Evans |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053726315 PECOS PAC ID: 4587997473 Enrollment ID: I20210923003272 |
| Provider Name | Teresa Pham |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376685966 PECOS PAC ID: 7214249309 Enrollment ID: I20211001001438 |
| Provider Name | Tiffany Marcoe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083182950 PECOS PAC ID: 8921347303 Enrollment ID: I20211014000949 |
| Provider Name | Christine Kantor |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235145764 PECOS PAC ID: 6103821921 Enrollment ID: I20211018002826 |
| Provider Name | Nayab Davis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942782321 PECOS PAC ID: 0547512030 Enrollment ID: I20211028000089 |
| Provider Name | Justin-veni Echague |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104072941 PECOS PAC ID: 8224215454 Enrollment ID: I20211101002461 |
| Provider Name | Samuel Cox |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972608974 PECOS PAC ID: 2264524503 Enrollment ID: I20211102000547 |
| Provider Name | Hemali B. Jardosh |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144537218 PECOS PAC ID: 6709066558 Enrollment ID: I20211102002021 |
| Provider Name | Michelle Williams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346389459 PECOS PAC ID: 5294763496 Enrollment ID: I20211103002313 |
| Provider Name | Van-anh Huynh |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770036212 PECOS PAC ID: 4688072622 Enrollment ID: I20211103002363 |
| Provider Name | Cassandra Lappegaard |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962742627 PECOS PAC ID: 3779727995 Enrollment ID: I20211104000515 |
| Provider Name | Jared Grant |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821472267 PECOS PAC ID: 7517261829 Enrollment ID: I20211105000424 |
| Provider Name | Leann Goslak |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205915451 PECOS PAC ID: 0840473484 Enrollment ID: I20211105001996 |
| Provider Name | Darshita Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588952576 PECOS PAC ID: 1951572858 Enrollment ID: I20211116002049 |
| Provider Name | Jenny Michelle Soo Hoo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124401427 PECOS PAC ID: 1850605767 Enrollment ID: I20211119001891 |
| Provider Name | Stephanie Corbin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124545603 PECOS PAC ID: 6406113760 Enrollment ID: I20211208000217 |
| Provider Name | Saher Sayed |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538610100 PECOS PAC ID: 5092074609 Enrollment ID: I20211227001087 |
| Provider Name | Jolie Denise Legate |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417615600 PECOS PAC ID: 7012309503 Enrollment ID: I20220112002678 |
| Provider Name | Bradley Habermehl |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356375463 PECOS PAC ID: 2365443314 Enrollment ID: I20220207001359 |
| Provider Name | Malay Pansheria |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821471657 PECOS PAC ID: 4082904214 Enrollment ID: I20220322002277 |
| Provider Name | Cody W Dagnall |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851036867 PECOS PAC ID: 9234512336 Enrollment ID: I20220823002422 |
| Provider Name | Kenny Fritz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881217347 PECOS PAC ID: 8123422474 Enrollment ID: I20220920001520 |
| Provider Name | Heather Elizabeth Stern |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053991497 PECOS PAC ID: 7719355379 Enrollment ID: I20221201003019 |
| Provider Name | Sheryl Reaves |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023301280 PECOS PAC ID: 7315194826 Enrollment ID: I20221205001104 |
| Provider Name | Douglas Herriott |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700885860 PECOS PAC ID: 4486793072 Enrollment ID: I20221230000376 |
| Provider Name | Claudine Jackson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659388114 PECOS PAC ID: 9931537776 Enrollment ID: I20221230000737 |
| Provider Name | Alison Atchison |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285921296 PECOS PAC ID: 6002084233 Enrollment ID: I20230120001881 |
| Provider Name | Tania Malara |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003966839 PECOS PAC ID: 6507965589 Enrollment ID: I20230123001344 |
| Provider Name | My Phuong Bui |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831544295 PECOS PAC ID: 0840586400 Enrollment ID: I20230215001536 |
| Provider Name | Vrajika Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588282156 PECOS PAC ID: 7315362217 Enrollment ID: I20230302002926 |
| Provider Name | Dana Hobi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619590403 PECOS PAC ID: 3779966551 Enrollment ID: I20230303001980 |
| Provider Name | Thuy Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811517899 PECOS PAC ID: 9537567003 Enrollment ID: I20230418002147 |
| Provider Name | Michael Phillips |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811993694 PECOS PAC ID: 5890828727 Enrollment ID: I20230419000520 |
| Provider Name | Eric Duresa |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285319889 PECOS PAC ID: 2466813365 Enrollment ID: I20230725001518 |
| Provider Name | Tesia Reed |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104388800 PECOS PAC ID: 4981023124 Enrollment ID: I20230727002237 |
| Provider Name | Fatima Karim |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538545611 PECOS PAC ID: 1850641333 Enrollment ID: I20230828002731 |
| Provider Name | Mehwish Ali |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548736754 PECOS PAC ID: 5092169573 Enrollment ID: I20231003000613 |
| Provider Name | Clayton Boyd |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720463698 PECOS PAC ID: 9436466901 Enrollment ID: I20231031000585 |
| Provider Name | Sheila Bogart |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902859812 PECOS PAC ID: 8527166305 Enrollment ID: I20231031001179 |
| Provider Name | Mary Jo Ference |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073734224 PECOS PAC ID: 4880580703 Enrollment ID: I20231108000437 |
| Provider Name | Prarthana Agrawal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013355288 PECOS PAC ID: 6103104195 Enrollment ID: I20231116000917 |
| Provider Name | Luqman Patel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831663640 PECOS PAC ID: 7810305448 Enrollment ID: I20240202002720 |
| Provider Name | David Gomez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891446373 PECOS PAC ID: 2163893132 Enrollment ID: I20240220004571 |
| Mailing Address | Practice Location Address |
|---|---|
| Myeyedr Optometry Of Wisconsin, Llc 1950 Old Gallows Rd Ste 520, Vienna, VA 22182-3970 Ph: (703) 847-8899 | Myeyedr Optometry Of Wisconsin, Llc 2305 30th Ave, Kenosha, WI 53144-1411 Ph: (262) 597-2020 |
Dr. Ayman Tabani, OD Optometrist Medicare: Medicare Enrolled Practice Location: 9160 76th St Unit C, Kenosha, WI 53158 Phone: 262-808-4274 | |
James R Kriege, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 5300 52nd St, Kenosha, WI 53144 Phone: 262-658-8119 Fax: 262-658-8261 | |
Sterling At Pershing Optometrist Medicare: Not Enrolled in Medicare Practice Location: 7532 Pershing Blvd, Kenosha, WI 53142 Phone: 262-694-2400 Fax: 262-694-9456 | |
Dr. Laurie Ann Robertson, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 6125 Green Bay Rd, Suite 800, Kenosha, WI 53142 Phone: 262-654-0726 Fax: 262-654-4365 | |
Dr. Steven Ticknor, OD Optometrist Medicare: Medicare Enrolled Practice Location: 3621 Market Ln, Kenosha, WI 53144 Phone: 262-658-8119 | |
Dr. James R Ferwerda, M.D Optometrist Medicare: Not Enrolled in Medicare Practice Location: 7802 5th Ave, Kenosha, WI 53143 Phone: 262-658-2919 |