Peter M Agnone, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002729 Issued in MI

Practice address

11225 S Saginaw St
Grand Blanc, MI 48439-1285

Phone

(810) 694-3937

Fax

(810) 694-9876

NPI assigned

Oct 6, 2006

Last updated

Jan 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hello@grandblanceyes.com

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.

• Grand Blanc Eyes PLLC

  • Optician
  • Grand Blanc, MI
  • NPI 1902998099

  Optometrist

  Medicare reassignment NPD
• Complete Chiropractic Care, Inc

  • Chiropractor
  • Grand Blanc, MI
  • NPI 1437215639
  NPD

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1477640845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11225 S SAGINAW ST",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391285",
            "telephone_number": "810-694-3937",
            "fax_number": "810-694-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11225 S SAGINAW ST",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391285",
            "telephone_number": "810-694-3937",
            "fax_number": "810-694-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNONE",
        "first_name": "PETER",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "1012177",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS OF MICHIGAN",
            "identifier": "0995464",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "900B511570",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "16441",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944505380",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Hello@grandblanceyes.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "11225 S Saginaw St",
            "city": "Grand Blanc",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484391285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Advanced Physical Therapy Center, Inc
• Advanced Rehab Management Services
• Advanced Rehab Network
• Advanced Screening LLC
• Matthew John Agnone, OD
• Ceilidh Ahearn
• Sheraz Ahmad, M.D.
• Khaja Fasiuddin Ahmed Mohammed
• Badar I Ahmed, M.D.
• Maruf Ahmed, DO

• Optometrist in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.

Verify at the official NPI Registry.