DR. MARY ELLEN TECLAW (O.D.) – Optometrist, NPI 1750824959

DR. MARY ELLEN TECLAW (O.D.) is a healthcare provider. based in Madison, Wisconsin. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 3440-35 (WI). The NPI Number for DR. MARY ELLEN TECLAW (O.D.) is 1750824959

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARY ELLEN TECLAW (O.D.)
NPI
1750824959
Phone
(608) 833-0062
Address
503 COMMERCE DR
Enumeration Date
21 November 2016
Last Update Date
6 August 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6088330062
Graduation Year
2016 (10 years ago)
PAC ID
7315204336
Group Practice PAC ID
5294818589
Professional Enrollment ID
I20171129003320
Address ID
WI537194941MA503XXDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

798 OPTOMETRY in WI

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Provider Addresses for DR. MARY ELLEN TECLAW (O.D.)

  • 503, Commerce Drive, All Saints Neighborhood, Middleton Junction, Madison, Dane County, Wisconsin, 53719, United States

    MADISON, WI 537194941

    Phone: (608) 833-0062

    Type: Mailing

  • 17495, West Capitol Drive, Brookfield, Waukesha County, Wisconsin, 53045, United States

    SUITE D

    BROOKFIELD, WI 530452059

    Phone: (262) 797-9638

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 43 Open Payments records for all available years, with a total value of $1,723.

Total Amount is formed as General ($1,723) + Research ($0) + Ownership ($0) = $1,723.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($520).

Total Amount

$1,723

General + Research + Ownership

Payments

43

Total payment records

General Amount

$1,723

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-11-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171129003320IOptometryWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system8282$0
92250Photography of the retina6060$0
99212Established patient office or other outpatient visit, 10-19 minutes2214$0
92004New patient complete exam of visual system1919$0
View full utilization report →

Insurance plans in this area (ZIP 53719)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294818589View full group profile
NameSpecialtyState
O P T O M E T R YWI
O P T O M E T R YWI
O P T O M E T R YWI
O P T O M E T R YWI

Reviews

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Frequently asked questions

What is the standard ID for DR. MARY ELLEN TECLAW (O.D.) in the U.S.?
In the U.S., DR. MARY ELLEN TECLAW (O.D.) is identified by NPI 1750824959.
Does the public listing show DR. MARY ELLEN TECLAW (O.D.) as active?
DR. MARY ELLEN TECLAW (O.D.)'s NPI record reflects an active status in NPPES.
Which specialty label fits DR. MARY ELLEN TECLAW (O.D.)?
NPPES ties DR. MARY ELLEN TECLAW (O.D.) to Optometrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is DR. MARY ELLEN TECLAW (O.D.) tied to Madison, Wisconsin?
If you are local to Madison, Wisconsin, DR. MARY ELLEN TECLAW (O.D.) may be relevant to your search.
Who maintains DR. MARY ELLEN TECLAW (O.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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