Individual provider Active NPI

Michael Brayden Lundquist, OD, FAAO, FSLS

  • Corneal and Contact Management Optometrist
  • Goodyear, AZ
National Provider Identifier
1013390285
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
2115 Issued in AZ
Practice address
2580 N Litchfield Rd
Goodyear, AZ 85395-2049
Phone
(623) 932-2020
NPI assigned
Jul 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 3222 TN
Corneal and Contact Management Optometrist 152WC0802X 10186731-9934 UT
Corneal and Contact Management Optometrist 152WC0802X 2115 AZ Primary

Addresses

Primary practice location

2580 N Litchfield Rd
Goodyear, AZ 85395-2049

Mailing address

2580 N Litchfield Rd
Goodyear, AZ 85395-2049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161115002296 AZ Practitioner - Optometry 1850605171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christopher T Furey OD PLCGroup PAC ID 6608773809, 6 clinicians

Practice addresses (Care Compare)

2580 N Litchfield Rd
Goodyear, AZ 85395-2049
Phone (623) 932-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2115AZMDCorneal and Contact Management Optometrist
10186731-9934UTMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher T Furey OD PLC CurrentSince Oct 8, 2016 Accepting new patients
West Valley Vision Center, Inc Past Accepting new patients

Locations

2580 N Litchfield Rd
Goodyear, AZ 85395
Phone (623) 932-2020

Interoperability endpoints

  • Direct secure messaging: michael.lundquist.p3@direct.midwesternuniversity.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1013390285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 N LITCHFIELD RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 N LITCHFIELD RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952049",
            "telephone_number": "623-932-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDQUIST",
        "first_name": "MICHAEL",
        "middle_name": "BRAYDEN",
        "name_prefix": "Dr.",
        "credential": "OD, FAAO, FSLS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-06",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TN",
            "license": "3222",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "UT",
            "license": "10186731-9934",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "AZ",
            "license": "2115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.