Peter J. Kurtz, O.D., LLC
Organization Active NPI Optometrist · Menominee, MI
NPI 1427304583 · NPPES record last updated Jul 26, 2012
Key facts
- NPI
- 1427304583
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- PETER J. KURTZ, O.D., LLC
- Practice address
- 801 1St St
Menominee, MI 49858-3231 - Phone
- (906) 863-2330
- Fax
- (906) 863-3794
- NPI assigned
- Jul 26, 2012
- Organization subpart
- No
Authorized official
- Name
- Peter J. Kurtz, O.D.
- Title
- Owner
- Phone
- (906) 863-2330
Other NPIs on the same Medicare enrollment 1
-
Peter J. Kurtz, OD
Practitioners 1
-
Peter J. Kurtz, OD
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Peter J. Kurtz OD LLC |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930087950 | MI | DME Supplier - Physician - Optometrist | 1951429356 |
1 other NPI on this enrollment Practice locations: Menominee, MI |
| O20120808000467 | MI | Part B Supplier - Clinic/Group Practice | 1951429356 |
Receives reassigned benefits from 1 practitioner Practice locations: Menominee, MI |
National Provider Directory
Locations
801 1st St
Menominee, MI 49858
Phone (906) 863-2330
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
801 1St St
Menominee, MI 49858-3231
Mailing address
801 1St St
Menominee, MI 49858-3231
Phone (906) 863-2330
Other providers in Menominee, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.