Individual provider Active NPI

Michael C Breckel, O. D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1477653392
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
03874T Issued in TX
Practice address
6400 Fannin St
18TH Floor
Houston, TX 77030-1511
Phone
(713) 559-5200
Fax
(713) 795-0709
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 03874T TX Primary

Addresses

Primary practice location

6400 Fannin St
18TH Floor
Houston, TX 77030-1511

Mailing address

6400 Fannin St
18TH Floor
Houston, TX 77030-1511
Phone (713) 559-5200

Other identifiers 1

IdentifierTypeStateIssuer
104402601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110323000211 TX Practitioner - Optometry 1254514672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 2961732193, 206 clinicians

Practice addresses (Care Compare)

11920 Astoria Blvd
Suite 292
Houston, TX 77089-6155
Phone (713) 486-7970

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.63 of 100Reported as group
Quality
68.75
Promoting interoperability
100
Improvement activities
40
Cost
72.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03874TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Jun 1, 2021 Accepting new patients

Locations

6411 Fannin St
Fl 7
Houston, TX 77030
Phone (713) 704-1777

11920 Astoria Blvd
Ste 292
Houston, TX 77089
Phone (713) 486-7970

6400 Fannin St
Ste 1800
Houston, TX 77030
Phone (713) 486-9400

6400 Fannin St
Fl 18
Houston, TX 77030
Phone (713) 559-1777

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1477653392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST",
            "address_2": "18TH FLOOR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301511",
            "telephone_number": "713-559-5200",
            "fax_number": "713-795-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST",
            "address_2": "18TH FLOOR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301511",
            "telephone_number": "713-559-5200",
            "fax_number": "713-795-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRECKEL",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "03874T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104402601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.