CENTRAL OTOLOGIC LTD (NPI# 1295700565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295700565 |
| Entity Type | Organization |
| Organization Name | CENTRAL OTOLOGIC LTD |
| Practice Address |
888 Thackeray Trail Suite # 108 Oconomowoc WI 53066 |
| Practice Telephone | 2625670505 |
| Practice Fax Number | 2625670778 |
| Mailing Telephone | 2625670505 |
| Mailing Fax Number | 2625670778 |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MICHAEL CHARLES JANOWAK (PRESIDENT) |
| Authorized Official Telephone | 2625670505 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | RAILROAD MEDICARE | C01716 | 01 |
| WI | 32684000 | 05 | |
| WI | DEAN HEALTH PLAN | 551343 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659330736 | Central Otologic Ltd | Otolaryngology | 2750 Golf Road, Delafield, WI 53018 | 2006-03-20 |
| 1851369771 | Central Otologic Ltd | Otolaryngology | 201 N Mayfair Road, Ste 545, Milwaukee, WI 53266 | 2006-03-08 |
| 1932177862 | Central Otologic Ltd | Otolaryngology | 123 Hospital Drive, Ste 106, Watertown, WI 53098 | 2006-03-08 |
| Street Address |
888 THACKERAY TRAIL SUITE # 108 |
| City | OCONOMOWOC |
| State | WI |
| Zip Code | 53066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144292723 | Michael G. O'mara | Internal Medicine | 888 Thackeray Trail, Oconomowoc Medical Clinic, Oconomowoc, WI 53066 | 2006-02-07 |
| 1801998786 | Laurel Sue Andres | Social Worker | 888 Thackeray Trail, Suite 105, Oconomowoc, WI 53066-4342 | 2006-09-02 |
| 1043245459 | Andrew John Schroettner | Psychiatry & Neurology | 888 Thackeray Trail, #211, Oconomowoc, WI 53066-4641 | 2006-07-12 |
| 1184659591 | Mark H Rossing | Psychiatry & Neurology | 888 Thackeray Trail, #211, Oconomowoc, WI 53066-4641 | 2006-07-12 |
| 1932174117 | Dean Louis Martinelli | Otolaryngology | 888 Thackeray Trail, Suite 108, Oconomowoc, WI 53066 | 2006-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376109082 | Sharon Legwinski | Occupational Therapist | 2195 N. Summit Way, Oconomowoc, WI 53066 | 2019-05-17 |
| 1033676390 | Paladina Health, LLC | Family Medicine | Paladina Health Oconomowoc Sentry Equipment Circle, 966 Blue Ribbon Circle N, Oconomowoc, WI 53066 | 2019-02-22 |
| 1689145500 | Oconomowoc Developmental Training Center of Wisconsin LLC | Residential Treatment Facility, Emotionally Disturbed Children | 36100 Genesee Lake School, Oconomowoc, WI 53066 | 2018-12-17 |
| 1649748203 | Ginny Dacquisto | Dietitian, Registered | 1134 Lily Rd, Oconomowoc, WI 53066 | 2018-11-12 |
| 1174000764 | Aimee M Metzger | Social Worker | 405 E Forest St Ste 113, Oconomowoc, WI 53066 | 2018-07-26 |
| 1023482569 | Forefront Dermatology, S.c. | Dermatology | 1320 Pabst Farms Cir, Suite 180, Oconomowoc, WI 53066 | 2015-11-20 |
| 1962890475 | Monica Rodriguez | Counselor | 405 East Forest Street, Suite 119, Oconomowoc, WI 53066 | 2015-01-06 |
| 1518384643 | Kimberley Bevan | Pharmacist | 1284 East Summit Avenue, Suite 100, Oconomowoc, WI 53066 | 2014-03-26 |
| 1699098905 | Heidi Eckroth Nunnemacher | Counselor | 35315 Genesee Lake Road, Oconomowoc, WI 53066 | 2010-03-02 |
| 1669705240 | Oconomowoc Development Training Center Ll | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3222 N. Silver Cedar Rd., Oconomowoc, WI 53066 | 2009-09-14 |
| Find all providers in zip 53066 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700027810 | Donald S. Blatnik | Otolaryngology | 4555 Hewitts Point Rd, Oconomowoc, WI 53066-3314 | 2009-03-19 |
| 1780799841 | Mark W Flick | Otolaryngology | 915 Summit Ave, Oconomowoc, WI 53066-3994 | 2006-08-20 |
| 1285601070 | Michael Charles Janowak | Otolaryngology | 888 Thackeray Trl, Ste 108, Oconomowoc, WI 53066-4342 | 2006-03-01 |
| 1932174117 | Dean Louis Martinelli | Otolaryngology | 888 Thackeray Trail, Suite 108, Oconomowoc, WI 53066 | 2006-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104156 | Alliance Ent and Hearing Center, Sc | Otolaryngology | 2524 E Webster Place, Suite 201, Milwaukee, WI 53211-4257 | 2020-11-04 |
| 1962969915 | Alliance Ent & Hearing Center, S.c. | Otolaryngology | 2500 W Layton Ave Ste 230, Milwaukee, WI 53221-5421 | 2019-02-26 |
| 1851822076 | Fort Health Care Inc | Otolaryngology | 123 Hospital Dr Suite 106a, Watertown, WI 53098 | 2017-03-21 |
| 1184010977 | Chad Michael Ennis | Otolaryngology | 1 S Park St Fl 6, Madison, WI 53715-1375 | 2015-04-08 |
| 1487055133 | Sam Khalili | Otolaryngology | 2801 W Kinnickinnic River Pkwy # 680, Milwaukee, WI 53215 | 2014-09-12 |
| 1760803795 | Gary Miller | Otolaryngology | 3467 Northwood Rd, Suamico, WI 54313-8250 | 2013-12-17 |
| 1629320007 | Peter Uy Lee | Otolaryngology | 1341 Boundary Rd, Middleton, WI 53562-3843 | 2012-10-09 |
| 1700145091 | Kenneth Brian Lewoczko | Otolaryngology | 600 Highland Ave., H4/831, Uw Hospital and Clinics, Madison, WI 53792 | 2012-05-08 |
| 1962768267 | Christopher Joseph Lee | Otolaryngology | 500 W. Drexel Ave, Suite 300, Oak Creek, WI 53154-2060 | 2012-04-11 |
| 1871814715 | Norval Eldred Bernhardt | Otolaryngology | 9 Holt Ct, Madison, WI 53719-3036 | 2010-06-15 |
| Find all providers with the same taxonomy | ||||
| City | OCONOMOWOC |
| Zip Code | 53066 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.