| Eye Centers Of Racine And Kenosha Ltd | |
|
13200 Globe Dr Ste 216, Mt Pleasant, WI 53177-1605 | |
| (262) 637-0500 | |
| (262) 635-8027 |
| Full Name | Eye Centers Of Racine And Kenosha Ltd |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 13200 Globe Dr Ste 216, Mt Pleasant, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710905781 | NPI | - | NPPES |
| 100202317 | Medicaid | WI | |
| 0631860001 | Other | WI | NGS ADMINISTAR |
| 38713800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | Inder P Singh |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1063430023 PECOS PAC ID: 0244291375 Enrollment ID: I20041022000140 |
| Provider Name | Stephen J Pruett |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427070259 PECOS PAC ID: 1052509221 Enrollment ID: I20110103000962 |
| Provider Name | Radha K Sanka |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1508042060 PECOS PAC ID: 8325179518 Enrollment ID: I20120507000210 |
| Provider Name | Jeff R Banas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619328606 PECOS PAC ID: 4688968266 Enrollment ID: I20160804000423 |
| Provider Name | Jessica G Schiffbauer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659723328 PECOS PAC ID: 3678851367 Enrollment ID: I20220425002392 |
| Provider Name | Eric Duresa |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285319889 PECOS PAC ID: 2466813365 Enrollment ID: I20230725001518 |
| Mailing Address | Practice Location Address |
|---|---|
| Eye Centers Of Racine And Kenosha Ltd 3805b Spring St, Suite 140, Racine, WI 53405-1641 Ph: (262) 637-0500 | Eye Centers Of Racine And Kenosha Ltd 13200 Globe Dr Ste 216, Mt Pleasant, WI 53177-1605 Ph: (262) 637-0500 |