Individual provider Active NPI

Michael Thomas Powers, O.D.

  • Optometrist
  • Cincinnati, OH
National Provider Identifier
1487663365
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4165/T097 Issued in OH
Practice address
2749 Edmondson Rd
Located Inside Lenscrafters
Cincinnati, OH 45209-1912
Phone
(513) 631-5181
Fax
(513) 631-3517
NPI assigned
Aug 7, 2006
Last updated
Mar 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1175DT KY
Optometrist 152W00000X 18002498 IN
Optometrist 152W00000X 4165/T097 OH Primary

Addresses

Primary practice location

2749 Edmondson Rd
Located Inside Lenscrafters
Cincinnati, OH 45209-1912

Mailing address

4060 Waterford Way
Cincinnati, OH 45245-1956
Phone (513) 720-3417

Other identifiers 2

IdentifierTypeStateIssuer
H969700OtherOHMEDICARE
0001188MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090305000009 OH Practitioner - Optometry 9234295965 Reassigns benefits to 1 organization
I20221020001344 OH Practitioner - Optometry 9234295965 Practice locations: Cincinnati, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002498INMDOptometrist
1175DTKYMDOptometrist
4165/T097OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Red Bank Eye Associate, LLC Optometrist PastSince Jan 19, 1999 Accepting new patients

Organizations & group practices 2

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1487663365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 WATERFORD WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451956",
            "telephone_number": "513-720-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2749 EDMONDSON RD",
            "address_2": "LOCATED INSIDE LENSCRAFTERS",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091912",
            "telephone_number": "513-631-5181",
            "fax_number": "513-631-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1175DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002498",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4165/T097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "H969700",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001188",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.