Individual provider Active NPI

Todd James Riker, OD

  • Optometrist
  • Muskegon, MI
National Provider Identifier
1366420168
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004230 Issued in MI
Practice address
1266 E Sherman Blvd
Muskegon, MI 49444-1847
Phone
(231) 739-9009
Fax
(231) 733-0566
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004230 MI Primary

Addresses

Primary practice location

1266 E Sherman Blvd
Muskegon, MI 49444-1847

Mailing address

1266 E Sherman Blvd
Muskegon, MI 49444-1847
Phone (231) 739-9009

Other identifiers 2

IdentifierTypeStateIssuer
4694302MedicaidMI
4705139MedicaidMI

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
I20040412000202 MI Practitioner - Optometry 0042204547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoreline Ophthalmology PLLCGroup PAC ID 3678537628, 14 clinicians

Practice addresses (Care Compare)

1266 E Sherman Blvd
Muskegon, MI 49444-1847
Phone (231) 739-9009

3375 McCracken St
Norton Shores, MI 49441-3670
Phone (231) 755-2291

Merit-based Incentive Payment System (MIPS)

Final score
80.4 of 100Reported as group
Quality
89.51
Promoting interoperability
100
Improvement activities
40
Cost
45.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901004230MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreline Ophthalmology PLLC Optometrist CurrentSince Sep 28, 2004 Accepting new patients
Shoreline Ophthalmology, PLLC Current Accepting new patients
Wal-Mart Stores East, LP Past Accepting new patients
Cornerstone Optometry PLLC Optometrist PastSince Jan 1, 1990 Accepting new patients
Shoreline Optical, LLC Optometrist Past Accepting new patients

Locations

1401 W Main St
Ste 101
Fremont, MI 49412
Phone (231) 739-9009

1445 Sheldon Rd
Ste 100
Grand Haven, MI 49417
Phone (231) 739-9009

1266 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 737-4727

301 Center St
North Muskegon, MI 49445
Phone (231) 739-9009

3375 McCracken St
Norton Shores, MI 49441
Phone (231) 739-9009

625 E Savidge St
Spring Lake, MI 49456
Phone (616) 844-5650

Interoperability endpoints

  • Direct secure messaging: triker@shorelinevision.imwdirect.com

Organizations & group practices 5

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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1366420168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1266 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441847",
            "telephone_number": "231-739-9009",
            "fax_number": "231-733-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1266 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441847",
            "telephone_number": "231-739-9009",
            "fax_number": "231-733-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIKER",
        "first_name": "TODD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4694302",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4705139",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.