Blake Church, OD
Optometrist · New Berlin, WI
Blake Church, OD is an optometrist with a practice address in New Berlin, Wisconsin, and NPI 1104717024, issued on Jul 9, 2025. Check the license (Wisconsin 4089-35, as entered in NPPES) with the Wisconsin board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Blake Church
- Credential
- OD
- Primary taxonomy
- Optometrist 152W00000X
- License number
- 4089-35 WI
Self-reported in NPPES; status is on the state search - Practice location
- 16800 W Cleveland Ave, New Berlin, WI 53151
- Phone
- (414) 313-7121
- Enumerated
- Jul 9, 2025
- Record last updated
- Aug 3, 2025
- Medicare enrollment
- Enrolled (PECOS I20250917001115); accepts Medicare assignment
- Entity
- Type 1 · individual
Verify Blake Church in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Wisconsin board licenses this profession
Search for license 4089-35Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Bills Medicare through one group practice
- Wisconsin Vision, LLCGlendale, WI
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
11 optometrist records list a practice address in New Berlin
They are 11 of the 662 NPPES records with a practice address in New Berlin, and 1,161 optometrist records in Wisconsin.
All 11 in New Berlin → All 1,161 in Wisconsin → Every provider in New Berlin →
Other optometrist records in Wisconsin
- Katie Abata, O.D.Appleton, WI1043646623
- Brianna Adams, ODStoughton, WI1093605222
- Gerald Adams, ODWestby, WI1760479182
- James AdamsPortage, WI1154007953
- Lawrence Addison, O.D.Weston, WI1760794697
- Farzana AkterWaupun, WI1346821725
- Margarette Elaine Alcesto, ODShorewood, WI1669984563
- Robert Alexejun, O.D.Wausau, WI1235275009
- Carmen Alfonso-Kneiert, ODFort Atkinson, WI1710938634
- Jennifer Alvarez, O.D.Brookfield, WI1316255805
Common questions
What is Blake Church, OD's NPI number?
Blake Church, OD's National Provider Identifier (NPI) is 1104717024, issued on Jul 9, 2025. An NPI identifies a provider in billing; it is not a license.
Where is Blake Church, OD located?
The NPPES record lists a practice address at 16800 W Cleveland Ave, New Berlin, WI, 53151. Phone: (414) 313-7121. Providers update this record themselves, so call before visiting.
How can I verify Blake Church, OD's license?
NPPES lists Wisconsin license number 4089-35, as entered by the provider. Search the Wisconsin board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.