Individual provider Active NPI

Michael E Raim, O.D.

  • Corneal and Contact Management Optometrist
  • Destin, FL
National Provider Identifier
1205864402
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
OPC0001111 Issued in FL
Practice address
501 Harbor Blvd
Suite D
Destin, FL 32541-2348
Phone
(850) 837-9161
Fax
(850) 837-9162
NPI assigned
Jun 28, 2006
Last updated
Jan 5, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X OPC0001111 FL Primary
Occupational Vision Optometrist 152WX0102X OPC0001111 FL

Addresses

Primary practice location

501 Harbor Blvd
Suite D
Destin, FL 32541-2348

Mailing address

501 Harbor Blvd
Suite D
Destin, FL 32541-2348
Phone (850) 837-9161

Other identifiers 1

IdentifierTypeStateIssuer
1245500677OtherFLORGANIZATION NPI

Other names 1

  • Dr. Michael Edward Raim Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120113000632 FL Practitioner - Optometry 3971770967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

501 Harbor Blvd
Suite D
Destin, FL 32541-2348
Phone (850) 837-9161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1111FLMDDentist
OPC0001111FLMDCorneal and Contact Management Optometrist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1205864402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 HARBOR BLVD",
            "address_2": "SUITE D",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412348",
            "telephone_number": "850-837-9161",
            "fax_number": "850-837-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 HARBOR BLVD",
            "address_2": "SUITE D",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412348",
            "telephone_number": "850-837-9161",
            "fax_number": "850-837-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIM",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC0001111",
            "primary": true
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "FL",
            "license": "OPC0001111",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION NPI",
            "identifier": "1245500677",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "RAIM",
            "middle_name": "EDWARD",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Destin, FL

Sources for this page

Verify at the official NPI Registry.