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NPI Code Detail

MEDICARE: MILWAUKEE EYE CARE ASSOCIATES S.C.

MEDICARE: MILWAUKEE EYE CARE ASSOCIATES S.C.
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
1152W00000XOptometrist
2207W00000XOphthalmology PhysicianWI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10000002560OTHERWIDMERC PIN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609869858
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILWAUKEE EYE CARE ASSOCIATES S.C.
Provider Business Mailing Address
First Line : 1684 N PROSPECT AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53202-2498
Country : US
Telephone Number : 414-271-2020
Fax Number : 414-272-3932
Provider Business Practice Location Address
First Line : 1684 N PROSPECT AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53202-2408
Country : US
Telephone Number : 414-271-2020
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JASON NATHANIEL EDMONDS
Credential : MD
Telephone Number : 414-271-2020
Provider Enumeration Date : 08/23/2005
Last Update Date : 04/14/2026

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1336132828 — DR. SUSAN H CHESSHIRE M.D.
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1932192440 — DR. JAY A HEILMANN O.D.
Practice Location Address:
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1285627711 — DR. JAMES E GREENLEE M.D.
Practice Location Address:
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Practice Fax: 414-272-3932

Directions to “MILWAUKEE EYE CARE ASSOCIATES S.C. ” Practice Location

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