Individual provider Active NPI

Michael Gene Miller, OD

  • Student in an Organized Health Care Education/Training Program
  • Brockton, MA
National Provider Identifier
1447742630
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
940 Belmont St
Brockton, MA 02301-5596
Phone
(508) 583-4500
NPI assigned
Jun 4, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X Primary

Addresses

Primary practice location

940 Belmont St
Brockton, MA 02301-5596

Mailing address

506 Beacon St Apt 12
Boston, MA 02215-2347
Phone (610) 310-7961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20200122002868 NJ Practitioner - Optometry 0840625786 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quality Eye Associates, LLCGroup PAC ID 0345320008, 2 clinicians

Practice addresses (Care Compare)

2020 New Rd
Linwood, NJ 08221-1039
Phone (609) 927-2020

Merit-based Incentive Payment System (MIPS)

Final score
98.98 of 100Reported as group
Quality
97.97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Eye Associates, LLC Single Specialty CurrentSince Aug 1, 2021 Accepting new patients
Associated Retinal Consultants LLC Single Specialty CurrentSince Jun 21, 2021 Accepting new patients
Sai Vision Care LLC Single Specialty CurrentSince Oct 1, 2021 Accepting new patients
Associated Retinal Consultants LLC CurrentSince Jun 21, 2021 Accepting new patients

Locations

1440 Atlantic Ave
Atlantic City, NJ 08401
Phone (609) 345-3000

315 S Main St
Cape May Court House, NJ 08210
Phone (609) 465-0100

101 Court House South Dennis Rd
Cape May Court House, NJ 08210
Phone (609) 465-7926

2021 New Rd
Ste 6
Linwood, NJ 08221
Phone (609) 927-3373

2020 New Rd
Linwood, NJ 08221
Phone (609) 653-2080

628 Cedar Ln
Teaneck, NJ 07666
Phone (201) 837-7300

251 S Lincoln Ave
Vineland, NJ 08361
Phone (856) 691-8188

Organizations & group practices 4

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": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1447742630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 BEACON ST APT 12",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022152347",
            "telephone_number": "610-310-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "508-583-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHAEL",
        "middle_name": "GENE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.