Justin B Michaels, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

Practice address

23002 Lake Center Dr
Lake Forest, CA 92630-6801

Phone

(949) 454-1064

Fax

(949) 454-4111

NPI assigned

May 19, 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 names 1

• Justin M Bobo Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Southern California College of Optometry, 2004

Medicare assignment

May accept Medicare assignment

Group practices

Michaels and Vu OD a Professional CorporationGroup PAC ID 8527157437, 3 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michaels & Vu OD a Professional Corporation

  dba South County Eye Care Optometric Group

  • Optometrist
  • Lake Forest, CA
  • NPI 1376748368
  Medicare reassignment Care Compare group NPD Authorized official
• Michaels and Vu Op Apc

  • Optometrist
  • Lake Forest, CA
  • NPI 1265623987
  NPD Authorized official
• H Kenneth Kopolow O.D & Assoc P.C

  dba Dr. Kenneth Kopolow O.D.

  • Optometrist
  • Las Vegas, NV
  • NPI 1336186444
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1174576904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23002 LAKE CENTER DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926306801",
            "telephone_number": "949-454-1064",
            "fax_number": "949-454-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23002 LAKE CENTER DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926306801",
            "telephone_number": "949-454-1064",
            "fax_number": "949-454-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELS",
        "first_name": "JUSTIN",
        "middle_name": "B",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTIN",
            "last_name": "BOBO",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Azin Meshkinpour, M.D., M.P.H.
• Nabila Emil Mettias, SLPA
• Micah Hamilton Chiropractic Inc. (South OC Chiropractic)
• Michaels & Vu OD a Professional Corporation (South County Eye Care Optometric Group)
• Michaels and Vu Op Apc
• Mika Diagnostic Services
• Shelby Miller
• Connie Milne
• Minerva Medical Supplies, Inc.
• Minimally Invasive Medical Group

• Optometrist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.