Michael Anthony Wolf, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD1369 Issued in TN

Practice address

122 Old Gray Station Rd Ste 1
Gray, TN 37615-3434

Phone

(423) 477-2020

Fax

(423) 477-2196

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Envision Professional Group PLLC 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

72.65 of 100Reported as group

Quality

45.3

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Envision Professional Group, PLLC

  • Clinic/Center
  • Marion, VA
  • NPI 1427155472

  TN

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1376575050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 OLD GRAY STATION RD STE 1",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376153434",
            "telephone_number": "423-477-2020",
            "fax_number": "423-477-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 OLD GRAY STATION RD STE 1",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376153434",
            "telephone_number": "423-477-2020",
            "fax_number": "423-477-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD1369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3598164",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Wellmont Medical Associates, Inc.
• Angela Marie Williams, BS
• Heather Marie Wine, MSN, FNP-C
• Jill W Wireman, MD
• Timothy Andy Wooten, DPT
• Jefferson Andrew Young

• All providers in Gray, TN
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.