Audry Lynn Poquette, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004657 Issued in MI

Practice address

200 Fairbanks St
Ste 1
Iron Mountain, MI 49801-1510

Phone

(906) 774-8280

Fax

(906) 774-8290

NPI assigned

Aug 25, 2011

Sex

Female

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 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, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Northern Eye Care Associates, P.C.Group PAC ID 2860650686, 2 clinicians

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.

• Northern Eye Care Associates, P.C.

  • Optometrist
  • Iron Mountain, MI
  • NPI 1699051193
  Medicare reassignment Care Compare group NPD
• Northern Eye Care Associates, P.C.

  • Optometrist
  • Iron Mountain, MI
  • NPI 1548455231
  NPD (past)

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1568742229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FAIRBANKS ST",
            "address_2": "STE 1",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498011510",
            "telephone_number": "906-774-8280",
            "fax_number": "906-774-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FAIRBANKS ST",
            "address_2": "STE 1",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498011510",
            "telephone_number": "906-774-8280",
            "fax_number": "906-774-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POQUETTE",
        "first_name": "AUDRY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-25",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Phillips
• Heidi Picord
• Carol Pilot, LPN
• Curtis D. Pitts, MSW
• Peggy Claire Pontti, CRNA
• Beau David Poquette, O.D.
• Shannon M Powell, CCC
• Amy K Powers, RN
• Premise Health of Michigan Medical PC (LP Building Solutions Iron Mountain)
• Jacob Prusi

• Optometrist in Iron Mountain, MI
• Providers in Iron Mountain, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.