Individual provider Active NPI

Michelle Rountree, OD

  • Optometrist
  • Miami, FL
National Provider Identifier
1063438901
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3831 Issued in FL
Practice address
10360 SW 186 St #970150
Miami, FL 33197
Phone
(954) 222-2222
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3831 FL Primary

Addresses

Primary practice location

10360 SW 186 St #970150
Miami, FL 33197

Mailing address

10360 SW 186 St #970150
Miami, FL 33197

Other identifiers 2

IdentifierTypeStateIssuer
AF740OtherFLMEDICARE PTAN
6208622 00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3831FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sidney J Stern Visual Health Centers PA Optometrist PastSince Nov 1, 2005 Accepting new patients
Sidney J Stern Visual Health Centers PA Optometrist Past Accepting new patients

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1063438901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10360 SW 186 ST #970150",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10360 SW 186 ST #970150",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33197",
            "telephone_number": "954-222-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUNTREE",
        "first_name": "MICHELLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AF740",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6208622 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.