Individual provider Active NPI

Michael Albert Christensen, OD

  • Optometrist
  • Vestal, NY
National Provider Identifier
1356909972
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV009005 Issued in NY
Practice address
3455 Vestal Pkwy E
Vestal, NY 13850-2134
Phone
(607) 722-2020
Fax
(607) 722-3937
NPI assigned
May 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 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 TUV009005 NY Primary

Addresses

Primary practice location

3455 Vestal Pkwy E
Vestal, NY 13850-2134

Mailing address

3455 Vestal Pkwy E
Vestal, NY 13850-2134
Phone (607) 722-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190711000591 NY Practitioner - Optometry 5496080541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Optometry Professional PLLCGroup PAC ID 5890169841, 26 clinicians

Practice addresses (Care Compare)

100 Rano Blvd
Vestal, NY 13850-2776
Phone (607) 260-1516

3455 Vestal Pkwy E
Vestal, NY 13850-2147
Phone (607) 722-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV009005NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Optometry PLLC Optometrist CurrentSince Jul 5, 2024 Accepting new patients
New York Optometry Professional PLLC Optometrist CurrentSince Dec 10, 2022 Accepting new patients

Locations

75 Main St
Sidney, NY 13838
Phone (607) 563-2442

3455 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 722-2020

100 Rano Blvd
Vestal, NY 13850
Phone (607) 260-1516

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": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1356909972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502134",
            "telephone_number": "607-722-2020",
            "fax_number": "607-722-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502134",
            "telephone_number": "607-722-2020",
            "fax_number": "607-722-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "MICHAEL",
        "middle_name": "ALBERT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.