Shoreline Ophthalmology, PLLC
Organization Active NPI Optometrist · North Muskegon, MI
NPI 1194910307 · NPPES record last updated May 9, 2022
Key facts
- NPI
- 1194910307
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- SHORELINE OPHTHALMOLOGY, PLLC
- Practice address
- 301 Center St
North Muskegon, MI 49445-3104 - Phone
- (231) 744-4580
- Fax
- (231) 744-2869
- NPI assigned
- Sep 11, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Michelle Cassens
- Title
- Executive Director
- Phone
- (231) 739-9009
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 8
Practitioners 12
-
Emily J Faccin, OD
-
David James Rawlinson, D.O.
-
Nathan Paul Reed, D.O.
-
Timothy D Vorgias, O.D.
-
Jessica Wilson, OD
-
Deborah R Wu, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041118000693 | MI | Part B Supplier - Clinic/Group Practice | 3678537628 |
Receives reassigned benefits from 10 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Spring Lake, MI; North Muskegon, MI; Muskegon, MI; Grand Haven, MI; Fremont, MI |
| O20060613000017 | MI | Part B Supplier - Clinic/Group Practice | 3678537628 |
Receives reassigned benefits from 7 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fremont, MI; Grand Haven, MI; Muskegon, MI; North Muskegon, MI |
National Provider Directory
- Tax ID family
- Shoreline Opthalmology
Locations
301 Center St
North Muskegon, MI 49445
Phone (231) 739-9009
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
301 Center St
North Muskegon, MI 49445-3104
Mailing address
1266 E Sherman Blvd
Muskegon, MI 49444-1847
Phone (231) 739-9009
Other providers in North Muskegon, MI
- Jessica Anna Pedersen
- Jessica Rae Rogers
- Sharon Rubick
- William F Seieroe
- Sharon Rubick
- Shoreline Optical, LLC
- Smile North Muskegon PC
- Charles O Somers
- Bethanie Grace Swier
- True You Coaching and Counseling
All providers in North Muskegon, MI · Optometrist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.