Individual provider Active NPI

Michael Holland

  • Optometrist
  • Raleigh, NC
National Provider Identifier
1083728752
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1365 Issued in NC
Practice address
603 New Bern Ave
Raleigh, NC 27601-1513
Phone
(919) 828-9085
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1365 NC Primary

Addresses

Primary practice location

603 New Bern Ave
Raleigh, NC 27601-1513

Mailing address

603 New Bern Ave
Raleigh, NC 27601-1513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20120911000555 NC Practitioner - Optometry 6305094699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

603 New Bern Ave
Raleigh, NC 27601-1513
Phone (919) 828-9085

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1365NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Holland & Holland Eye Care Center Optometry PLLC Optometrist CurrentSince Mar 18, 2013 Accepting new patients
Lincoln Community Health Center Incorporated Past Accepting new patients

Locations

502 S Duke St
Durham, NC 27701
Phone (919) 688-5617

603 New Bern Ave
Raleigh, NC 27601
Phone (919) 828-9085

Interoperability endpoints

  • Direct secure messaging: mholland228880@direct.medicine.duke.edu

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1083728752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011513",
            "telephone_number": "919-828-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.