Shelly D Baker, OD
Individual provider Active NPI Optometrist · Manistique, MI
NPI 1336256288 · NPPES record last updated Aug 14, 2020
Key facts
- NPI
- 1336256288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901003805 (MI)
- Practice address
- 1252 W Lakeshore Dr
Manistique, MI 49854-1364 - Phone
- (906) 341-3933
- Fax
- (906) 341-3944
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1252 W Lakeshore Dr
Manistique, MI 49854-1364
Phone (906) 341-3933
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060927000200 | MI | Practitioner - Optometry | 4183629033 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shelly D. Baker, OD, PC | Optometrist | Current |
Accepting new patients |
Locations
1252 W Lakeshore Dr
Manistique, MI 49854
Phone (906) 341-3933
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901003805 | MI | Yes |
Addresses
Primary practice location
1252 W Lakeshore Dr
Manistique, MI 49854-1364
Mailing address
1252 W Lakeshore Dr
Manistique, MI 49854-1364
Phone (906) 341-3933
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4173092 | Medicaid | MI | |
| 9006765000 | Other | MI | BCBS |
| 900A760100 | Other | BLUE CROSS & BLUE SHIELD | |
| 4152181 | Medicaid | MI |
Other providers in Manistique, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.