Individual provider Active NPI

Andrew J Hart, O.D.

  • Optometrist
  • Sault Sainte Marie, MI
National Provider Identifier
1396772422
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003981 Issued in MI
Practice address
3763 I 75 Business Spur
Sault Sainte Marie, MI 49783-3613
Phone
(906) 632-0588
Fax
(906) 632-0661
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2602 FL
Optometrist 152W00000X 4901003981 MI Primary

Addresses

Primary practice location

3763 I 75 Business Spur
Sault Sainte Marie, MI 49783-3613

Mailing address

3763 I 75 Business Spur
Sault Sainte Marie, MI 49783-3613
Phone (906) 632-0588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100611000245 FL Practitioner - Optometry 3072643493

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC2602FLMDOptometrist
4901003981MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Centers of Florida Optometrist Past Accepting new patients
Hart Hart & Associates OD PA Optometrist Past Accepting new patients
The Retina & Macular Degeneration Center of SW Florida PLLC PastSince May 26, 2010 Accepting new patients

Organizations & group practices 3

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1396772422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3763 I 75 BUSINESS SPUR",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497833613",
            "telephone_number": "906-632-0588",
            "fax_number": "906-632-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3763 I 75 BUSINESS SPUR",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497833613",
            "telephone_number": "906-632-0588",
            "fax_number": "906-632-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2602",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sault Sainte Marie, MI

Sources for this page

Verify at the official NPI Registry.