Individual provider Active NPI

Michael G Sternberg, OD

  • Optometrist
  • Williamsburg, VA
National Provider Identifier
1417933342
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0601000783 Issued in VA
Practice address
1107 Richmond Rd
Williamsburg, VA 23185-2894
Phone
(757) 229-4222
Fax
(757) 564-3422
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0601000783 VA Primary

Addresses

Primary practice location

1107 Richmond Rd
Williamsburg, VA 23185-2894

Mailing address

1107 Richmond Rd
Williamsburg, VA 23185-2894
Phone (757) 229-4222

Other identifiers 2

IdentifierTypeStateIssuer
231451OtherVAMAMSI/ NITED HELATH CAR
075580OtherVAANTHEM, BLUE CROSS & BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0601000783VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeanne I Ruff OD LLC Optometrist Past Accepting new patients

Organizations & group practices 1

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417933342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 RICHMOND RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852894",
            "telephone_number": "757-229-4222",
            "fax_number": "757-564-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 RICHMOND RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852894",
            "telephone_number": "757-229-4222",
            "fax_number": "757-564-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERNBERG",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601000783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI/ NITED HELATH CAR",
            "identifier": "231451",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM, BLUE CROSS & BLUE",
            "identifier": "075580",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.