Individual provider Active NPI

Abby Maus, O.D.

  • Optometrist
  • Warren, MI
National Provider Identifier
1104109446
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004666 Issued in MI
Practice address
29245 Ryan Rd
Suite 100
Warren, MI 48092-4284
Phone
(586) 558-2981
Fax
(586) 558-8838
NPI assigned
Sep 22, 2011
Last updated
Jul 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004666 MI Primary

Addresses

Primary practice location

29245 Ryan Rd
Suite 100
Warren, MI 48092-4284

Mailing address

2338 Franklin Rd
Berkley, MI 48072-1816
Phone (989) 372-4766

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
I20111026000353 MI Practitioner - Optometry 8426221094 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care One, PLLC Optometrist CurrentSince Nov 5, 2023 Accepting new patients
E.C. One, PLLC Optometrist CurrentSince Jun 29, 2020 Accepting new patients
Piero a. Simone, M.D., P.C. Optometrist CurrentSince Jul 27, 2016 Accepting new patients

Locations

2984 Henry St
Norton Shores, MI 49441
Phone (231) 737-7700

105 W Exchange St
Spring Lake, MI 49456
Phone (616) 846-0620

314 W Savidge St
Spring Lake, MI 49456
Phone (616) 844-7000

8950 Telegraph Rd
Taylor, MI 48180
Phone (313) 291-2020

29245 Ryan Rd
Ste 100
Warren, MI 48092
Phone (586) 558-2981

Organizations & group practices 3

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": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1104109446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 FRANKLIN RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721816",
            "telephone_number": "989-372-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29245 RYAN RD",
            "address_2": "SUITE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924284",
            "telephone_number": "586-558-2981",
            "fax_number": "586-558-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUS",
        "first_name": "ABBY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.