Individual provider Active NPI

Michael Jay Giese, O.D., PH.D.

  • Optometrist
  • Davie, FL
National Provider Identifier
1306972286
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5453 T2365 Issued in OH
Practice address
3200 S University Dr
Terry 1456
Davie, FL 33328-2018
Phone
(954) 262-1456
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5453 T2365 OH Primary
Optometrist 152W00000X OFC 33 FL
Optometrist 152W00000X 8976T CA

Addresses

Primary practice location

3200 S University Dr
Terry 1456
Davie, FL 33328-2018

Mailing address

9365 Fields Ertel Rd
Cincinnati, OH 45249-8302
Phone (513) 677-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8976TCAMDOptometrist
OFC 33FLMDOptometrist
5453 T2365OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Mark Lynn & Associates, PLLC Optometrist CurrentSince Feb 5, 2020 Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist CurrentSince Feb 5, 2020 Accepting new patients

Locations

1701 Gallatin Pike N
Madison, TN 37115
Phone (615) 868-2000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1306972286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9365 FIELDS ERTEL RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452498302",
            "telephone_number": "513-677-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "address_2": "TERRY 1456",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIESE",
        "first_name": "MICHAEL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "O.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5453 T2365",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OFC 33",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8976T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.