Individual provider Active NPI

Michael J Connors, O.D.

  • Optometrist
  • Homer, AK
National Provider Identifier
1457424780
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
030-0000258 Issued in VT
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, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 Other name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000554 AK Practitioner - Optometry 5395727598 Practice locations: Anchorage, AK

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
314AKMDRegistered Dietitian
030-0000258VTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew 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

Verify at the official NPI Registry.