Individual provider Active NPI

Hannah Faupel Mikolaizyk, OD

  • Optometrist
  • Holland, MI
National Provider Identifier
1417693656
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005624APP22 Issued in MI
Practice address
2657 120TH Ave
Holland, MI 49424-8692
Phone
(616) 395-0606
NPI assigned
May 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005624APP22 MI Primary

Addresses

Primary practice location

2657 120TH Ave
Holland, MI 49424-8692

Mailing address

2657 120TH Ave
Holland, MI 49424-8727
Phone (616) 395-0606

Other names 1

  • Dr. Hannah Faupel Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220630000323 MI Practitioner - Optometry 8628458130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Eyecare Center PCGroup PAC ID 1557424405, 4 clinicians

Practice addresses (Care Compare)

2657 120TH Ave
Holland, MI 49424-8692
Phone (616) 395-0606

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005624APP22MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nichols Optical Inc Optometrist CurrentSince May 1, 2024 Accepting new patients
Lakeshore Eyecare Center PC Optometrist CurrentSince Jun 1, 2022 Accepting new patients

Locations

2657 120th Ave
Holland, MI 49424
Phone (616) 395-0606

336 W Front St
Traverse City, MI 49684
Phone (231) 941-5440

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1417693656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2657 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248727",
            "telephone_number": "616-395-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2657 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248692",
            "telephone_number": "616-395-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOLAIZYK",
        "first_name": "HANNAH",
        "middle_name": "FAUPEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-10",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005624APP22",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "FAUPEL",
            "prefix": "DR.",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.