Individual provider Active NPI

Lance Rambo, OD

  • Optometrist
  • Walker, MI
National Provider Identifier
1578458741
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005893 Issued in MI
Practice address
3303 Alpine Ave NW Ste a
Walker, MI 49544-1605
Phone
(616) 649-4703
NPI assigned
Jun 10, 2025
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005893 MI Primary

Addresses

Primary practice location

3303 Alpine Ave NW Ste a
Walker, MI 49544-1605

Mailing address

1415 Wealthy St SE Apt 310
Grand Rapids, MI 49506-2804
Phone (906) 236-2550

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260605002582 MI Practitioner - Optometry 2466923818

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

131 W Wahsington St
Suite B
Marquette, MI 49855-4378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005893MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
National Vision Inc Optometrist CurrentSince Jun 15, 2025 Accepting new patients

Locations

3303 Alpine Ave NW
Ste A
Walker, MI 49544
Phone (616) 649-4703

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1578458741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 WEALTHY ST SE APT 310",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062804",
            "telephone_number": "906-236-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 ALPINE AVE NW STE A",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495441605",
            "telephone_number": "616-649-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMBO",
        "first_name": "LANCE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walker, MI

Sources for this page

Verify at the official NPI Registry.