Andrea Mott, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004653 Issued in MI

Practice address

1015 S Lincoln Rd
Escanaba, MI 49829-2100

Phone

(906) 786-5181

NPI assigned

Jul 12, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Andrea St. John Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Optometry

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Up Ophthalmology Associates PCGroup PAC ID 4587677232, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Up Optometry

  • Optometrist
  • Escanaba, MI
  • NPI 1497792386
  Medicare reassignment Care Compare group NPD
• Paul R Gayeff OD PC

  • Optometrist
  • Escanaba, MI
  • NPI 1285767509
  NPD (past)
• Prevea Clinic, Inc.

  • Family Medicine Physician
  • Chippewa Falls, WI
  • NPI 1588110969
  NPD (past)

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1316235237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S LINCOLN RD",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498292100",
            "telephone_number": "906-786-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S LINCOLN RD",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498292100",
            "telephone_number": "906-786-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTT",
        "first_name": "ANDREA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-12",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900B10059",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "ST. JOHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Moore Joy Counseling
• Joyce M Moore, MA LPC
• Brian Scott Moravec, DC
• Amber Morrison
• Ashley Kristina Moss
• Kayela Murray
• Kristy Mykkanen
• Mary Frances Myrick, MD
• Sarah Jean Nault, P.T.
• Chastity Nelson

• Optometrist in Escanaba, MI
• Providers in Escanaba, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.