Susan Marie Moon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003215 Issued in MI

Practice address

621 E Lake St
Tawas City, MI 48763-9213

Phone

(989) 984-0929

Fax

(989) 984-0931

NPI assigned

May 20, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Marie Ward-Moon Former name

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

Specialty

Optometry

Education

Ferris State College - College of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Sunrise Vision Care

  • Optometrist
  • Tawas City, MI
  • NPI 1982933586

  MI, Optometrist

  Medicare reassignment NPD Authorized official
• Optometric Associates PC

  • Optometrist
  • Longmont, CO
  • NPI 1730299116
  NPD (past)

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1497912174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 231",
            "city": "EAST TAWAS",
            "state": "MI",
            "postal_code": "487300231",
            "telephone_number": "989-984-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 E LAKE ST",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639213",
            "telephone_number": "989-984-0929",
            "fax_number": "989-984-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "WARD-MOON",
            "middle_name": "MARIE",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vera Lee Middleton
• Laurie Miller
• Molly A Minard, PA-C
• Cheri L Mioduch
• Dennis W Mollard, DDS
• Ruth Ann Moore, OT
• John Christopher Moran, LMSW
• Justine Ashley Morris, FNP
• Elizabeth Myers, FNP-BC
• Mymichigan Medical Center Tawas

• All providers in Tawas City, MI
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; 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.