Individual provider Active NPI

Stacy Maier Noyes, OD

  • Optometrist
  • Jenison, MI
National Provider Identifier
1326064239
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003950 Issued in MI
Practice address
381 Baldwin St
Jenison, MI 49428-6909
Phone
(616) 457-4443
Fax
(616) 457-4715
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003950 MI Primary

Addresses

Primary practice location

381 Baldwin St
Jenison, MI 49428-6909

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070926000688 MI Practitioner - Optometry 8426143132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1998
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

381 Baldwin St
Jenison, MI 49428-6909
Phone (616) 457-4443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Michigan, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince May 3, 2021 Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince May 3, 2021 Accepting new patients

Locations

6143 Kalamazoo Ave SE
Grand Rapids, MI 49508
Phone (616) 554-7775

803 W State St
Hastings, MI 49058
Phone (269) 945-9724

1617 N West Ave
Jackson, MI 49202
Phone (517) 780-3828

800 S Brown St
Jackson, MI 49203
Phone (517) 787-8890

381 Baldwin St
Ste A
Jenison, MI 49428
Phone (616) 457-4443

381 Baldwin St
Jenison, MI 49428
Phone (616) 457-4443

5349 W Main St
Kalamazoo, MI 49009
Phone (269) 349-7627

5465 Gull Rd
Kalamazoo, MI 49048
Phone (269) 349-7631

1281 M 89
Plainwell, MI 49080
Phone (269) 684-1071

3576 Alpine Ave NW
Walker, MI 49544
Phone (616) 784-4999

1717 28th St SW
Wyoming, MI 49519
Phone (616) 531-4370

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 3

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1326064239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494286909",
            "telephone_number": "616-457-4443",
            "fax_number": "616-457-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOYES",
        "first_name": "STACY",
        "middle_name": "MAIER",
        "name_prefix": "Ms.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenison, MI

Sources for this page

Verify at the official NPI Registry.