Active NPI
Amanda B Gorsline, O.D.
- Optometrist
- Okemos, MI
National Provider Identifier
1417935925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901004143
- Practice address
- 1669 Hamilton Rd
Suite 200
Okemos, MI 48864-1956 - Phone
- (517) 349-4743
- Fax
- (517) 349-0096
- NPI assigned
- Jan 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901004143 | MI | Primary |
Addresses
Primary practice location
1669 Hamilton Rd
Suite 200
Okemos, MI 48864-1956
Mailing address
2764 Moyer Rd
Williamston, MI 48895-9569
Phone (517) 655-7072
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Ferris State College - College of Optometry, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1669 Hamilton Rd
Suite 200
Okemos, MI 48864-1961
Phone (517) 349-4743
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901004143 | MI | MD | Optometrist |
Interoperability endpoints
- amanda.gorsline@direct.revolutionehr.com
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.
-
- Pediatric Optometrist
- Okemos, MI
- NPI 1881754406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584403200000",
"number": "1417935925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2764 MOYER RD",
"city": "WILLIAMSTON",
"state": "MI",
"postal_code": "488959569",
"telephone_number": "517-655-7072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1669 HAMILTON RD",
"address_2": "SUITE 200",
"city": "OKEMOS",
"state": "MI",
"postal_code": "488641956",
"telephone_number": "517-349-4743",
"fax_number": "517-349-0096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORSLINE",
"first_name": "AMANDA",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-04",
"last_updated": "2020-03-17",
"certification_date": "2020-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901004143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Okemos, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.