Eric Siesel

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003938 Issued in MI

Practice address

3265 S. M-129
Sault Sainte Marie, MI 49783

Phone

(906) 635-9347

Fax

(906) 635-1113

NPI assigned

Sep 14, 2005

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 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

Specialty

Optometry

Education

Southern College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Eric J. Siesel, O.D.P.C.

  • Optometrist
  • Sault Sainte Marie, MI
  • NPI 1407044688

  MI, Optometrist

  Medicare reassignment NPD Authorized official
• Lily Group

  • Optometrist
  • Sault Sainte Marie, MI
  • NPI 1619839552
  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1528053683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3265 S. M-129",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "49783",
            "telephone_number": "906-635-9347",
            "fax_number": "906-635-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3265 S. M-129",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "49783",
            "telephone_number": "906-635-9347",
            "fax_number": "906-635-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIESEL",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944461338",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiyi Sherman
• Gaurang Mugatlal Sheth, PHYSICAL THERAPIST
• Cheyanne Kallie-Autumn Shotwell
• Lindsay Susan Showers, M.D.
• Clayton C Shunk, D.D.S.
• Kyle Russell Silvas
• Debbie J Sirk
• Daniel Mark Skog, MA CCC-SLP
• Jessie Anne Skog
• Jill Slater

• All providers in Sault Sainte Marie, MI
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; 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.