Matthew Black, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901005112 Issued in MI

Practice address

3901 Alpine Ave NW
Comstock Park, MI 49321-8350

Phone

(616) 647-2213

NPI assigned

Jun 20, 2018

Last updated

Sep 8, 2020By the provider in NPPES

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

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

Ferris State College - College of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• White Pine Eyecare PLLC

  • Optometrist
  • Cedar Springs, MI
  • NPI 1669220380
  Medicare reassignment NPD Authorized official
• Alpine Vision Center PLLC

  • Optometrist
  • Comstock Park, MI
  • NPI 1225642408
  Authorized official Same address or phone

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1124512447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 ALPINE AVE NW",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493218350",
            "telephone_number": "616-647-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 ALPINE AVE NW",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493218350",
            "telephone_number": "616-647-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MATTHEW",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cara Ansmits
• Amanda Barry
• William Von Benson Jr.
• Mohamad G Beydoun, PHARMD
• Beyond Blessed Services (N/a)
• Blessing Keepers Adult Living LLC
• Stephane Bohemier, DC
• Jerry E Bowser
• Alexis Mary Brannan, LLMSW
• Brent Reeve PLLC (Comstock Park Family Chiropractic)

• Optometrist in Comstock Park, MI
• Providers in Comstock Park, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.