Individual provider Active NPI

Micah Ramon Girard, O.D.

  • Optometrist
  • Cocoa, FL
National Provider Identifier
1285749911
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
FL3800 Issued in FL
Practice address
1941 Michigan Ave
Cocoa, FL 32922-5728
Phone
(321) 638-3931
Fax
(321) 638-0788
NPI assigned
Aug 21, 2006
Last updated
Feb 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X FL3800 FL Primary

Addresses

Primary practice location

1941 Michigan Ave
Cocoa, FL 32922-5728

Mailing address

1941 Michigan Ave
Cocoa, FL 32922-5728
Phone (321) 638-3931

Other identifiers 1

IdentifierTypeStateIssuer
620988200MedicaidFL

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
I20041216000559 FL Practitioner - Optometry 5193782647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Florida Professional PLLCGroup PAC ID 3870960032, 70 clinicians

Practice addresses (Care Compare)

1941 Michigan Ave
Cocoa, FL 32922-5728
Phone (321) 638-3931

4788 Hodges Blvd
Suite 205
Jacksonville, FL 32224-7223
Phone (904) 992-9991

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FL3800FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Florida Professional PLLC Optometrist CurrentSince Sep 23, 2024 Accepting new patients

Locations

1941 Michigan Ave
Cocoa, FL 32922
Phone (321) 638-3931

4788 Hodges Blvd
Ste 205
Jacksonville, FL 32224
Phone (904) 992-9991

5330 SW College Rd
#O
Ocala, FL 34474
Phone (352) 512-0560

Organizations & group practices 2

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1285749911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 MICHIGAN AVE",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329225728",
            "telephone_number": "321-638-3931",
            "fax_number": "321-638-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 MICHIGAN AVE",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329225728",
            "telephone_number": "321-638-3931",
            "fax_number": "321-638-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRARD",
        "first_name": "MICAH",
        "middle_name": "RAMON",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "FL3800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620988200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

Verify at the official NPI Registry.