Thunder Bay Optometry PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

THUNDER BAY OPTOMETRY PLLC

Practice address

1011 W Washington Ave
Alpena, MI 49707-2929

Phone

(989) 356-3937

Fax

(989) 356-3938

NPI assigned

May 9, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Anthony G Luongo, ODNPI 1609226034

Title

Owner/Optometrist

Phone

(989) 356-3937

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anthony G Luongo, OD

  • Optometrist
  • Alpena, MI
  • NPI 1609226034

  MI, Optometrist

  Medicare reassignment Care Compare group NPD Authorized official
• Desiree Rose Miller, OD

  • Optometrist
  • Alpena, MI
  • NPI 1568148781

  MI, Optometrist

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1104516707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W WASHINGTON AVE",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497072929",
            "telephone_number": "989-356-3937",
            "fax_number": "989-356-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W WASHINGTON AVE",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497072929",
            "telephone_number": "989-356-3937",
            "fax_number": "989-356-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THUNDER BAY OPTOMETRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "LUONGO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "989-356-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rachel Timm
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• All providers in Alpena, MI
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.