Individual provider Active NPI

Michael Lockhart Jr., OD

  • Optometrist
  • Massillon, OH
National Provider Identifier
1073572806
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5601 Issued in OH
Practice address
915 Lincoln Way E
Massillon, OH 44646-6833
Phone
(330) 833-1091
Fax
(330) 833-1092
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5601 OH Primary

Addresses

Primary practice location

915 Lincoln Way E
Massillon, OH 44646-6833

Mailing address

1151 Melscheimer Rd SW
East Sparta, OH 44626-9752
Phone (330) 484-3203

Other identifiers 1

IdentifierTypeStateIssuer
2642439MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060420000026 OH Practitioner - Optometry 4880603786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

915 Lincoln Way E
Massillon, OH 44646-6833
Phone (330) 833-1091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Union Optical Services Inc. Current Accepting new patients
Dr. Mike Lockhart, Jr. & Associates, Inc. Optometrist CurrentSince Aug 21, 2009 Accepting new patients

Locations

220 Federal Ave NW
Massillon, OH 44647
Phone (330) 833-1091

915 Lincoln Way E
Massillon, OH 44646
Phone (330) 833-1091

18054 Royalton Rd
Strongsville, OH 44136
Phone (440) 268-0765

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1073572806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 MELSCHEIMER RD SW",
            "city": "EAST SPARTA",
            "state": "OH",
            "postal_code": "446269752",
            "telephone_number": "330-484-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446466833",
            "telephone_number": "330-833-1091",
            "fax_number": "330-833-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKHART",
        "first_name": "MICHAEL",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2642439",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

Verify at the official NPI Registry.