Paul D Gammage, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003318 Issued in MI

Practice address

3232 Central Blvd
Hudsonville, MI 49426-1439

Phone

(616) 669-2530

Fax

(616) 669-3646

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hudsonville Vision Care IncGroup PAC ID 2769409168, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Hudsonville Vision Care Inc

  • Optometrist
  • Hudsonville, MI
  • NPI 1972695617
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1104918820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 CENTRAL BLVD",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261439",
            "telephone_number": "616-669-2530",
            "fax_number": "616-669-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3232 CENTRAL BLVD",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261439",
            "telephone_number": "616-669-2530",
            "fax_number": "616-669-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMMAGE",
        "first_name": "PAUL",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "900G010150",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "MI3318",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P31367F",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "382911868",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2704876",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Hudsonville, MI
• Providers in Hudsonville, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.