Individual provider Active NPI

Michael Shane Murphy, OD

  • Optometrist
  • Williamsville, NY
National Provider Identifier
1073518759
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006295-1 Issued in NY
Practice address
8560 Main St Ste 1
Williamsville, NY 14221-7435
Phone
(716) 632-6102
Fax
(716) 204-8639
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006295-1 NY Primary

Addresses

Primary practice location

8560 Main St Ste 1
Williamsville, NY 14221-7435

Mailing address

8560 Main St Ste 1
Williamsville, NY 14221-7435
Phone (716) 632-6102

Other identifiers 17

IdentifierTypeStateIssuer
000390180003OtherNYBLUE CROSS/BLUE SHIELD
251744484OtherNYNORTH AMERICAN PREFERRED
2091959OtherNYUNITED HEALTH CARE
02506169MedicaidNY
7290362OtherNYINDEPENDENT HEALTH
NY6295OtherNYEYEMED
000390180001OtherNYCOMMUNITY BLUE
251744484OtherNYNOVA
000390180002OtherNYCOMMUNITY BLUE
115838CSOtherNYPREFERRED CARE
P00412808OtherNYMEDICARE RAILROAD
00025494903OtherNYUNIVERA
161578122OtherNYEMPIRE - UNITED HEALTHCAR
161578122OtherNYNOVA
251744484OtherNYEMPIRE - UNITED HEALTHCAR
7461797OtherNYAETNA
9382737OtherNYPHCS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040610000094 NY Practitioner - Optometry 1951384312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Infinity Eye OD PLLCGroup PAC ID 6507849957, 2 clinicians

Practice addresses (Care Compare)

8770 Transit Rd
Suite 2
East Amherst, NY 14051-1786
Phone (716) 770-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006295-1NYMDOptometrist
006295NYMDOccupational Therapist

Organizations & group practices 1

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1073518759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8560 MAIN ST STE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217435",
            "telephone_number": "716-632-6102",
            "fax_number": "716-204-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8560 MAIN ST STE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217435",
            "telephone_number": "716-632-6102",
            "fax_number": "716-204-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "MICHAEL",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006295-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000390180003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH AMERICAN PREFERRED",
            "identifier": "251744484",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2091959",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02506169",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "7290362",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "NY6295",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BLUE",
            "identifier": "000390180001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOVA",
            "identifier": "251744484",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BLUE",
            "identifier": "000390180002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "115838CS",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00412808",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00025494903",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE - UNITED HEALTHCAR",
            "identifier": "161578122",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOVA",
            "identifier": "161578122",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE - UNITED HEALTHCAR",
            "identifier": "251744484",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7461797",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9382737",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.