Individual provider Active NPI

Michelle Lizardi Rivera, O.D.

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1043434533
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003127 Issued in PA
Practice address
7205 Bonneval Rd
Jacksonville, FL 32256-7565
Phone
(904) 296-0098
NPI assigned
Apr 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003127 PA Primary

Addresses

Primary practice location

7205 Bonneval Rd
Jacksonville, FL 32256-7565

Mailing address

1412 Fairmount Ave
Philadelphia, PA 19130-2908
Phone (904) 296-0098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170221000049 PA Practitioner - Optometry 8921145327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey L Morer OD PCGroup PAC ID 7719870807, 50 clinicians

Practice addresses (Care Compare)

12 Penns TRL
Suite 154
Newtown, PA 18940-3438
Phone (888) 964-6681

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003127PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey L. Morer, OD, PC Optometrist CurrentSince May 17, 2021 Accepting new patients
Jeffrey L. Morer, OD, PC Optometrist CurrentSince May 17, 2021 Accepting new patients
Senior Medical Services, Inc Past Accepting new patients
Millis Mobile Eye Care, LLC Optometrist PastSince Mar 21, 2021 Accepting new patients

Locations

12 Penns Trl
Ste 154
Newtown, PA 18940
Phone (215) 675-3005

Organizations & group practices 4

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1043434533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 FAIRMOUNT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191302908",
            "telephone_number": "904-296-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7205 BONNEVAL RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567565",
            "telephone_number": "904-296-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MICHELLE",
        "middle_name": "LIZARDI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.