Active NPI
Jason Andrus
- Optometrist
- Dayton, OH
National Provider Identifier
1013319268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901004873
- Practice address
- 4100 W 3Rd St
Dayton, OH 45428-9000 - Phone
- (937) 268-6511
- NPI assigned
- Sep 18, 2014
- Last updated
- Sep 18, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901004873 | MI | Primary |
Addresses
Primary practice location
4100 W 3Rd St
Dayton, OH 45428-9000
Mailing address
425 Escott St
Big Rapids, MI 49307-1919
Phone (208) 521-2126
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2718 Ashman St
Apt a
Midland, MI 48640-4441
Phone (989) 486-3025
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901004873 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Modern Eye Care, PLLC | Optometrist | Current | Accepting new patients |
| Abp Eyesite PC | Optometrist | Current | Accepting new patients |
Locations
1234 E Broomfield St
Ste 6
Mt Pleasant, MI 48858
Phone (989) 773-2020
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Midland, MI
- NPI 1376134544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410998400000",
"number": "1013319268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 ESCOTT ST",
"city": "BIG RAPIDS",
"state": "MI",
"postal_code": "493071919",
"telephone_number": "208-521-2126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 W 3RD ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454289000",
"telephone_number": "937-268-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRUS",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-18",
"last_updated": "2014-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901004873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.