Mid-Modern Eye Care, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MID-MODERN EYE CARE, PLLC

Practice address

2718 Ashman St
Ste a
Midland, MI 48640

Phone

(989) 486-3025

NPI assigned

Feb 1, 2021

Organization subpart

No

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

Authorized official

Name

Shannon Zietz

Title

Billing Specialist

Phone

(989) 205-1260

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Andrus

  • Optometrist
  • Dayton, OH
  • NPI 1013319268

  MI

  Medicare reassignment NPD
• Michael Brewer

  • Adult Care Home Facility
  • Farwell, MI
  • NPI 1801518352
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1376134544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2718A ASHMAN ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2718 ASHMAN ST",
            "address_2": "STE A",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48640",
            "telephone_number": "989-486-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MODERN EYE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "ZIETZ",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "989-205-1260"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Midland, MI
• Providers in Midland, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.