Active NPI
Michael J Connors, O.D.
- Optometrist
- Homer, AK
National Provider Identifier
1457424780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 030-0000258
- Practice address
- PO Box 3622
Diamond Run Mall
Homer, AK 99603-3622 - Phone
- (802) 775-7251
- NPI assigned
- Nov 16, 2006
- Last updated
- Jan 16, 2017
- Sex
- Male
- 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 | 030-0000258 | VT | Primary |
Addresses
Primary practice location
PO Box 3622
Diamond Run Mall
Homer, AK 99603-3622
Mailing address
PO Box 3622
Homer, AK 99603
Phone (907) 435-7215
Other names 1
- Michael Amir
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120118000554 | AK | Practitioner - Optometry | 5395727598 | Practice locations: Anchorage, AK |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 314 | AK | MD | Registered Dietitian |
| 030-0000258 | VT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484524800000",
"number": "1457424780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3622",
"city": "HOMER",
"state": "AK",
"postal_code": "99603",
"telephone_number": "907-435-7215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 3622",
"address_2": "DIAMOND RUN MALL",
"city": "HOMER",
"state": "AK",
"postal_code": "996033622",
"telephone_number": "802-775-7251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNORS",
"first_name": "MICHAEL",
"middle_name": "J",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2017-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VT",
"license": "030-0000258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MICHAEL",
"last_name": "AMIR",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Homer, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.