Individual provider Active NPI

Michelle Jager Centi, O.D.

  • Optometrist
  • Bel Air, MD
National Provider Identifier
1366503104
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA 1449 Issued in MD
Practice address
223 Brierhill Dr Ste C
Bel Air, MD 21015-4948
Phone
(410) 420-3933
Fax
(410) 420-6399
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA 1449 MD Primary

Addresses

Primary practice location

223 Brierhill Dr Ste C
Bel Air, MD 21015-4948

Mailing address

223 Brierhill Dr Ste C
Bel Air, MD 21015-4948
Phone (410) 420-3933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20171114002140 CO Practitioner - Optometry 8325178130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA 1449MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Just for Grins Vision LLC Optometrist CurrentSince Oct 1, 2020 Accepting new patients
Just for Grins LLC Past Accepting new patients

Locations

6436 S US Highway 85-87
Ste C
Fountain, CO 80817
Phone (719) 392-5111

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366503104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 BRIERHILL DR STE C",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210154948",
            "telephone_number": "410-420-3933",
            "fax_number": "410-420-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 BRIERHILL DR STE C",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210154948",
            "telephone_number": "410-420-3933",
            "fax_number": "410-420-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CENTI",
        "first_name": "MICHELLE",
        "middle_name": "JAGER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA 1449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.