Individual provider Active NPI

Michaela Minichello

  • Optometrist
  • Cincinnati, OH
National Provider Identifier
1609250554
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6393 Issued in OH
Practice address
2121 Hatmaker St
Cincinnati, OH 45204-1947
Phone
(513) 363-4195
NPI assigned
Jul 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6393 OH Primary

Addresses

Primary practice location

2121 Hatmaker St
Cincinnati, OH 45204-1947

Mailing address

2121 Hatmaker St
Cincinnati, OH 45204-1947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160422000646 OH Practitioner - Optometry 5597064733 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6393OHMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
City of Cincinnati Current Accepting new patients
City of Cincinnati CurrentSince Mar 2, 2016 Accepting new patients
City of Cincinnati CurrentSince Mar 2, 2016 Accepting new patients
City of Cincinnati Past Accepting new patients

Locations

2121 Hatmaker St
Cincinnati, OH 45204
Phone (513) 363-0000

3101 Burnet Ave
Ofc
Cincinnati, OH 45229

Interoperability endpoints

  • Direct secure messaging: mminichello162105@direct.ochin.org

Organizations & group practices 4

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": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1609250554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 HATMAKER ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452041947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 HATMAKER ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452041947",
            "telephone_number": "513-363-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINICHELLO",
        "first_name": "MICHAELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-09",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.