Individual provider Active NPI

Michael Ray

  • Optometrist
  • Franklin, IN
National Provider Identifier
1528062908
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002113A Issued in IN
Practice address
110 N Jackson St
Franklin, IN 46131-1705
Phone
(317) 346-4107
Fax
(317) 346-4108
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002113A IN Primary

Addresses

Primary practice location

110 N Jackson St
Franklin, IN 46131-1705

Mailing address

110 N Jackson St
Franklin, IN 46131-1705
Phone (317) 346-4107

Other identifiers 1

IdentifierTypeStateIssuer
200059300AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040719001230 IN Practitioner - Optometry 7012996358

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002113AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Mobile Care Inc Optometrist CurrentSince Aug 7, 2009 Accepting new patients
Hearmax, PLLC Past Accepting new patients

Locations

12803 Lenover St
Dillsboro, IN 47018
Phone (812) 432-5226

110 N Jackson St
Franklin, IN 46131
Phone (317) 346-4107

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1528062908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N JACKSON ST",
            "city": "FRANKLIN",
            "state": "IN",
            "postal_code": "461311705",
            "telephone_number": "317-346-4107",
            "fax_number": "317-346-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N JACKSON ST",
            "city": "FRANKLIN",
            "state": "IN",
            "postal_code": "461311705",
            "telephone_number": "317-346-4107",
            "fax_number": "317-346-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002113A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200059300A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, IN

Sources for this page

Verify at the official NPI Registry.