Individual provider Active NPI

Laura Keller, OD

  • Optometrist
  • Mt Pleasant, MI
National Provider Identifier
1043836190
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005441 Issued in MI
Practice address
2865 S Lincoln Rd
Mt Pleasant, MI 48858-9085
Phone
(989) 773-7747
NPI assigned
Jun 24, 2020
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005441 MI Primary

Addresses

Primary practice location

2865 S Lincoln Rd
Mt Pleasant, MI 48858-9085

Mailing address

1321 Pine Ave
Alma, MI 48801-1242
Phone (989) 463-1139

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200805000539 MI Practitioner - Optometry 6406271675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Seals Tacia and Bartz OD PCGroup PAC ID 5294854105, 12 clinicians

Practice addresses (Care Compare)

2865 S Lincoln Rd
Pleasant Optics
Mt Pleasant, MI 48858-9085
Phone (989) 773-7747

Merit-based Incentive Payment System (MIPS)

Final score
71.23 of 100Reported as group
Quality
43.82
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005441MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Seals Tacia & Bartz OD PC Optometrist CurrentSince Jun 24, 2020 Accepting new patients
Seals Tacia & Bartz OD PC Optometrist Current Accepting new patients
Seals Tacia & Bartz OD PC Optometrist CurrentSince Jun 24, 2020 Accepting new patients
Seals Tacia & Bartz OD PC Optometrist PastSince Feb 1, 2022 Accepting new patients

Locations

1321 Pine Ave
Alma, MI 48801
Phone (989) 463-1139

322 N State St
Alma, MI 48801
Phone (989) 331-5030

2865 S Lincoln Rd
Mt Pleasant, MI 48858
Phone (989) 773-7747

235 N Mill St
Saint Louis, MI 48880
Phone (989) 681-2684

Interoperability endpoints

  • Direct secure messaging: laura.keller@mieyedoctor.direct.eyemdemr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1043836190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 PINE AVE",
            "city": "ALMA",
            "state": "MI",
            "postal_code": "488011242",
            "telephone_number": "989-463-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 S LINCOLN RD",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488589085",
            "telephone_number": "989-773-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "LAURA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.