Michael D. Tinkelman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG 000753 Issued in PA

Practice address

104 W Main St
Boalsburg, PA 16827-1347

Phone

(814) 466-2020

Fax

(814) 808-6165

NPI assigned

Dec 15, 2005

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1124004809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W MAIN ST",
            "city": "BOALSBURG",
            "state": "PA",
            "postal_code": "168271347",
            "telephone_number": "814-466-2020",
            "fax_number": "814-808-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W MAIN ST",
            "city": "BOALSBURG",
            "state": "PA",
            "postal_code": "168271347",
            "telephone_number": "814-466-2020",
            "fax_number": "814-808-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINKELMAN",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG 000753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0546259",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS IND",
            "identifier": "01496301",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GRP",
            "identifier": "02499800",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debbie Ann Stachowski
• Melissa Stafford
• Maria Stevens
• Ralph Robert Stoehr III, PT
• Karen Lee Tempest, DNP, CRNP
• Undeniably Fit, LLC (UFIT Thrive)
• Andrew Walker, DC
• Kerry Ellen Warburton, R.N.
• Amanda Dawn Woodle Stewart

• Optometrist in Boalsburg, PA
• Providers in Boalsburg, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.