Individual provider Active NPI

Michael P Weisgerber, O.D.

  • Optometrist
  • Lake City, SC
National Provider Identifier
1396847539
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1933 Issued in SC
Practice address
123 Epps St
Lake City, SC 29560-2449
Phone
(843) 374-5487
Fax
(843) 374-7342
NPI assigned
Sep 1, 2006
Last updated
Apr 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1933 SC Primary

Addresses

Primary practice location

123 Epps St
Lake City, SC 29560-2449

Mailing address

123 Epps St
Lake City, SC 29560-2449
Phone (843) 374-5487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20160920002257 SC Practitioner - Optometry 0749299097 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Eye Group, P.C.Group PAC ID 2466434717, shared by 5 NPIs, 10 clinicians

Practice addresses (Care Compare)

123 Epps St
Lake City, SC 29560-2449
Phone (843) 374-5487

90 Cedar Light LN
Little River, SC 29566-6978
Phone (843) 280-8779

Merit-based Incentive Payment System (MIPS)

Final score
96.67 of 100Reported as group
Quality
93.33
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1933SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Eye Group, P.C. CurrentSince Aug 9, 2016 Accepting new patients
Coastal Eye Group, P.C. CurrentSince Mar 8, 2023 Accepting new patients
Coastal Eye Group, P.C. CurrentSince Aug 9, 2016 Accepting new patients
Washington Eye Care PC PastSince Apr 27, 2006 Accepting new patients

Locations

1200 Highmarket St
Ste 200
Georgetown, SC 29440
Phone (803) 546-8421

123 Epps St
Lake City, SC 29560
Phone (843) 374-5487

90 Cedar Light Ln
Little River, SC 29566
Phone (843) 280-8779

4055 Highway 17
Murrells Inlt, SC 29576
Phone (843) 652-3937

401 79th Ave N
Myrtle Beach, SC 29572
Phone (843) 449-7115

Interoperability endpoints

  • Direct secure messaging: mweisgerber@ceg.intellechartdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1396847539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 EPPS ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602449",
            "telephone_number": "843-374-5487",
            "fax_number": "843-374-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 EPPS ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602449",
            "telephone_number": "843-374-5487",
            "fax_number": "843-374-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISGERBER",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, SC

Sources for this page

Verify at the official NPI Registry.