Dr Mary Katherine Ellis, MD is a
Ophthalmology physician based in Oconomowoc, Wisconsin. Dr Mary Katherine Ellis is licensed to practice in Wisconsin (license number 29428-020) and her current practice location is 915 Summit Ave, Oconomowoc, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(262) 569-2300.
NPI number for Dr Mary Katherine Ellis is 1679688774 and her current mailing address is 3301 W Forest Home Ave, Milwaukee, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1679688774.
Physician's Profile
| Full Name | Dr Mary Katherine Ellis |
|---|
| Gender | Female |
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| Speciality | Ophthalmology |
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| Location | 915 Summit Ave, Oconomowoc, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1679688774
- Provider Enumeration Date: 08/20/2006
- Last Update Date: 03/07/2023
Medical Identifiers
Medical identifiers for Dr Mary Katherine Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679688774 | NPI | - | NPPES |
| 31706000 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207W00000X | Ophthalmology | 29428-020 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mary Katherine Ellis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mary Katherine Ellis, MD
3301 W Forest Home Ave,
Milwaukee, WI 53215-2843
Ph: (414) 647-6326 | Dr Mary Katherine Ellis, MD
915 Summit Ave,
Oconomowoc, WI 53066-3994
Ph: (262) 569-2300 |
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