Individual provider Active NPI

Michael Katz, OD

  • Optometrist
  • Hatboro, PA
National Provider Identifier
1407996119
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002574 Issued in PA
Practice address
3225 Colonial Rd
Hatboro, PA 19040-1633
Phone
(631) 512-2063
NPI assigned
Feb 8, 2007
Last updated
Jan 9, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T004297 NY
Optometrist 152W00000X OEG002574 PA Primary
Occupational Vision Optometrist 152WX0102X OEG002574 PA
Vision Therapy Optometrist 152WV0400X OEG002574 PA
Sports Vision Optometrist 152WS0006X OEG002574 PA

Addresses

Primary practice location

3225 Colonial Rd
Hatboro, PA 19040-1633

Mailing address

3225 Colonial Rd
Hatboro, PA 19040-1633
Phone (631) 512-2063

Other identifiers 1

IdentifierTypeStateIssuer
236789OtherPAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120330000548 PA Practitioner - Optometry 4183884091 Reassigns benefits to 1 organization
I20170424002114 NJ Practitioner - Optometry 4183884091 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T004297NYMDOptometrist
OEG002574PAMDVision Therapy Optometrist

Organizations & group practices 2

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1407996119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 COLONIAL RD",
            "city": "HATBORO",
            "state": "PA",
            "postal_code": "190401633",
            "telephone_number": "631-512-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 COLONIAL RD",
            "city": "HATBORO",
            "state": "PA",
            "postal_code": "190401633",
            "telephone_number": "631-512-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T004297",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002574",
            "primary": true
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "PA",
            "license": "OEG002574",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "PA",
            "license": "OEG002574",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "PA",
            "license": "OEG002574",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "236789",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hatboro, PA

Sources for this page

Verify at the official NPI Registry.