Individual provider Active NPI

Jonathan David Hamer, O.D.

  • Optometrist
  • Ann Arbor, MI
National Provider Identifier
1154468676
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004354 Issued in MI
Practice address
117 S Main St
Ann Arbor, MI 48104-1902
Phone
(734) 665-5306
Fax
(734) 930-2383
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004354 MI Primary
Optometrist 152W00000X 1247 SC

Addresses

Primary practice location

117 S Main St
Ann Arbor, MI 48104-1902

Mailing address

23353 Portage Way
#2307
Novi, MI 48375-5401
Phone (248) 946-4291

Other identifiers 2

IdentifierTypeStateIssuer
1154468676MedicaidMI
JH004354OtherBCBS MICHIGAN

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
I20070713000784 MI Practitioner - Optometry 7315047701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SVS Vision IncGroup PAC ID 9931257110, 41 clinicians

Practice addresses (Care Compare)

118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 468-7612

6725 Park Ave
Allen Park, MI 48101-2033
Phone (313) 382-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901004354MIMDOptometrist
1247SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
SVS Vision Inc Optometrist CurrentSince Jan 1, 2013 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Jan 1, 2013 Accepting new patients
Pearle Vision Inc Past Accepting new patients
Pearle Vision Inc Optometrist Past Accepting new patients

Locations

6725 Park Ave
Allen Park, MI 48101
Phone (313) 382-0100

2555 Jackson Ave
Ann Arbor, MI 48103
Phone (734) 239-8900

22561 Gratiot Ave
Eastpointe, MI 48021
Phone (586) 350-2100

34505 Utica Rd
Fraser, MI 48026
Phone (586) 293-4198

355 S Broadway St
Lake Orion, MI 48362
Phone (248) 693-8666

3184 Gratiot Blvd
Marysville, MI 48040
Phone (810) 364-5520

1314 N Telegraph Rd
Monroe, MI 48162
Phone (734) 243-0195

118 Cass Ave
Mount Clemens, MI 48043
Phone (586) 464-1479

30120 Harper Ave
Saint Clair Shores, MI 48082
Phone (586) 778-7542

52799 Hayes Rd
Shelby Township, MI 48315
Phone (586) 247-2652

22320 Goddard Rd
Taylor, MI 48180
Phone (313) 299-8870

3110 Van Horn Rd
Trenton, MI 48183
Phone (734) 675-8197

3150 Alpine Ave NW
Ste F
Walker, MI 49544
Phone (616) 363-9831

29660 S Wixom Rd
Wixom, MI 48393
Phone (248) 313-5500

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1154468676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23353 PORTAGE WAY",
            "address_2": "#2307",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483755401",
            "telephone_number": "248-946-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S MAIN ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041902",
            "telephone_number": "734-665-5306",
            "fax_number": "734-930-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMER",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004354",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1247",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154468676",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MICHIGAN",
            "identifier": "JH004354",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.