Individual provider Active NPI

Michelle Cooper Cantrell, O.D.

  • Optometrist
  • Visalia, CA
National Provider Identifier
1407060320
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10757 TPA Issued in CA
Practice address
2830 W Main St
Visalia, CA 93291-4331
Phone
(559) 636-1000
Fax
(559) 733-7438
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10757 TPA CA Primary

Addresses

Primary practice location

2830 W Main St
Visalia, CA 93291-4331

Mailing address

2830 W Main St
Visalia, CA 93291-4331
Phone (559) 636-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070713000516 CA Practitioner - Optometry 6305946757 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Eye Surgeons a California Professional Medical CorporationGroup PAC ID 7810947397, 19 clinicians

Practice addresses (Care Compare)

1395 W Lacey Blvd
Hanford, CA 93230-5904
Phone (559) 585-3937

2830 W Main St
Visalia, CA 93291-4331
Phone (559) 636-1000

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
97.71
Improvement activities
40
Cost
66.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10757 TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Eye Surgeons, a California Professional Medical Corporation CurrentSince Dec 3, 2023 Accepting new patients
Pacific Eye Surgeons, a California Professional Medical Corporation Optometrist CurrentSince Dec 3, 2023 Accepting new patients
Sierra Eye Optometric Corp Optometrist Past Accepting new patients

Locations

1395 W Lacey Blvd
Hanford, CA 93230
Phone (559) 585-3937

931 Oak Park Blvd
Ste 201
Pismo Beach, CA 93449
Phone (805) 473-6640

816 E Enos Dr
Ste A
Santa Maria, CA 93454
Phone (805) 346-1717

2830 W Main St
Visalia, CA 93291
Phone (559) 636-1000

Organizations & group practices 10

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1407060320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 W MAIN ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932914331",
            "telephone_number": "559-636-1000",
            "fax_number": "559-733-7438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 W MAIN ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932914331",
            "telephone_number": "559-636-1000",
            "fax_number": "559-733-7438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "MICHELLE",
        "middle_name": "COOPER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10757 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.