Individual provider Active NPI

Kevin Leahy, OD

  • Optometrist
  • Battle Creek, MI
National Provider Identifier
1477112134
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005245 Issued in MI
Practice address
5500 Armstrong Rd
Battle Creek, MI 49037-7314
Phone
(269) 966-5600
NPI assigned
Jun 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005245 MI Primary

Addresses

Primary practice location

5500 Armstrong Rd
Battle Creek, MI 49037-7314

Mailing address

4422 E Rudolph Rd
Cedar, MI 49621-9401
Phone (231) 944-6159

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200506002174 MI Practitioner - Optometry 6709217789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Traverse City Ophthalmology PLLCGroup PAC ID 6608273412, 10 clinicians

Practice addresses (Care Compare)

3830 W Front St
Traverse City, MI 49684-8153
Phone (231) 935-8101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Traverse City Ophthalmology PLLC CurrentSince Aug 15, 2021 Accepting new patients

Locations

7800 US Highway 131 S
Ste C
Cadillac, MI 49601
Phone (231) 779-0320

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

5199 N Royal Dr
Traverse City, MI 49684
Phone (231) 486-0230

3830 W Front St
Traverse City, MI 49684
Phone (231) 929-3888

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1477112134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 E RUDOLPH RD",
            "city": "CEDAR",
            "state": "MI",
            "postal_code": "496219401",
            "telephone_number": "231-944-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 ARMSTRONG RD",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490377314",
            "telephone_number": "269-966-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAHY",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.