John Mark Michael, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

01033505 Issued in IN

Practice address

242 Willowgate LN
Indianapolis, IN 46260-1431

Phone

(317) 848-1611

NPI assigned

Jun 9, 2005

Last updated

Mar 4, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1578567426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 WILLOWGATE LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601431",
            "telephone_number": "317-848-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 WILLOWGATE LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601431",
            "telephone_number": "317-848-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01033505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100317670",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180007434",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley D Michael
• Catherine Michael, MD
• Emmy Jean Michael
• Helen Michael, M.D.
• John M Michael, MD
• Shanee Nelene Michael
• Gabrielle Michaeli, MD
• Lee Albert Michaelis, D.D.S.
• Lindsay Michaels
• Natalie D Michaels, CGC

• Ophthalmology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.