Individual provider Active NPI

Michael Kent Haskett, OD

  • Optometrist
  • South Boston, VA
National Provider Identifier
1215926647
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000062 Issued in VA
Practice address
2047 Hamilton Blvd
South Boston, VA 24592-2141
Phone
(434) 572-9733
Fax
(434) 572-9736
NPI assigned
Oct 18, 2005
Last updated
Jul 1, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000062 VA Primary

Addresses

Primary practice location

2047 Hamilton Blvd
South Boston, VA 24592-2141

Mailing address

2047 Hamilton Blvd
South Boston, VA 24592-2141
Phone (434) 572-9733

Other identifiers 4

IdentifierTypeStateIssuer
009206019MedicaidVA
063596OtherVABLUE CROSS BLUE SHIELD
410038621OtherVARAILROAD MEDICARE
0180770001OtherVACIGNA HEALTHCARE DMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20050323000184 VA Practitioner - Optometry 2365498441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12090 Jefferson Ave
Suite 1010
Newport News, VA 23606-4566
Phone (757) 249-4330

422 Oriana Rd
Newport News, VA 23608-3733
Phone (757) 875-0675

44727 Brimfield Dr
Ashburn, VA 20147-5920
Phone (571) 385-4600

Merit-based Incentive Payment System (MIPS)

Final score
91.89 of 100Reported as group
Quality
90.46
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000062VAMDOptometrist
1274VAMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Jun 16, 2025 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Jun 16, 2025 Accepting new patients
Ezephysical Therapy LLC PastSince Feb 5, 2019 Accepting new patients

Locations

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

12090 Jefferson Ave
Ste 1010
Newport News, VA 23606
Phone (757) 249-0737

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1215926647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2047 HAMILTON BLVD",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245922141",
            "telephone_number": "434-572-9733",
            "fax_number": "434-572-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2047 HAMILTON BLVD",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245922141",
            "telephone_number": "434-572-9733",
            "fax_number": "434-572-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASKETT",
        "first_name": "MICHAEL",
        "middle_name": "KENT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009206019",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "063596",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410038621",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE DMERC",
            "identifier": "0180770001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.