Ian Maisonville

Primary specialty

OptometristTaxonomy code 152W00000X

License

3645 Issued in TN

Practice address

3017 Indian Crest Dr
Pelham, AL 35124-4701

Phone

(205) 529-0557

NPI assigned

Sep 10, 2020

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

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Optometry

Education

University Alabama Birmingham - School of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Center of Oak Ridge,PCGroup PAC ID 8527040690, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75.96 of 100Reported as group

Quality

62.76

Improvement activities

40

Cost

69.54

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eye Center of Oak Ridge,PC

  • Ophthalmology Physician
  • Oak Ridge, TN
  • NPI 1235201393

  Optometrist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1497360002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 INDIAN CREST DR",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351244701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 INDIAN CREST DR",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351244701",
            "telephone_number": "205-529-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAISONVILLE",
        "first_name": "IAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Catherine Long, PH.D.
• Lori R Louis, M.D.
• Kimberly Renee Love, OT/L
• Lovett Osunde Lowery, OTR/L
• Robin Maddox
• Vickie Kelpke Maly, RPH
• Tamra Carlson Mann, OTR/L
• Kye L Mansfield, OD
• Amy Vanessa Marchant
• Tyler Alexander Mardis, PMHNP-BC

• Optometrist in Pelham, AL
• Providers in Pelham, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.