MEDICARE: ANDREW B ZOLOT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	MD-52802	IA
2	207WX0009X	Glaucoma Specialist (Ophthalmology) Physician	MD-52802	IA
3	207W00000X	Ophthalmology Physician	85008-20	WI

General Provider Information

NPI Number	:	1285258574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW B ZOLOT MD

Provider Business Mailing Address
First Line	:	4300 W LAYTON AVE STE 100
Second Line	:
City	:	GREENFIELD
State	:	WI
Zip	:	53220-4136
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 W LAYTON AVE STE 100
Second Line	:
City	:	GREENFIELD
State	:	WI
Zip	:	53220-4136
Country	:	US
Telephone Number	:	414-928-2020
Fax Number	:	414-210-3402

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2020
Last Update Date	:	08/04/2025

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