Samantha Renee Gagnon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901005125 Issued in MI

Practice address

7500 Challis Rd
Brighton, MI 48116-9416

Phone

(810) 263-4000

NPI assigned

Apr 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Regents of the University of Michigan

  • Optometrist
  • Ann Arbor, MI
  • NPI 1255356903
  Medicare reassignment Care Compare group NPD
• Regents of the University of Michigan

  • Optometrist
  • Brighton, MI
  • NPI 1902821572
  NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD
• Regents of the University of Michigan

  dba University of Michigan Health System

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regents of the University of Michigan

  dba University of Michigan Health System

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1184157596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 CHALLIS RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481169416",
            "telephone_number": "810-263-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "SAMANTHA",
        "middle_name": "RENEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011091",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Daniel Friedli, MD
• Evan Fry, PA-C
• John Douglas Furey, LMSW
• Emily Jean Gabbeart, M.D.
• Patrice Gage, CNP
• Gago Center for Fertility, PLLC
• Gago Ivf
• Laura April Gago, MD
• James Patrick Gallagher II, DO
• Amy Elizabeth Gallegos, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.