Individual provider Active NPI

Michael S Budahn, O.D.

  • Optometrist
  • Des Moines, IA
National Provider Identifier
1619126307
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002569 Issued in IA
Practice address
5201 SE 14TH St
Des Moines, IA 50320-1615
Phone
(515) 285-3568
NPI assigned
Sep 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 2108 NC
Optometrist 152W00000X 002569 IA Primary

Addresses

Primary practice location

5201 SE 14TH St
Des Moines, IA 50320-1615

Mailing address

14761 Lakeview Dr
Clive, IA 50325-7759
Phone (612) 599-8327

Other practice location 1

3702 High Point Rd
Greensboro, NC 27407-4628
Phone (336) 854-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20130920000361 IA Practitioner - Optometry 0648468090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5201 SE 14TH St
Des Moines, IA 50320-1615
Phone (515) 285-3568

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2108NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Eyecare, P.C. Optometrist CurrentSince May 15, 2019 Accepting new patients
Eyecare Partners, P.C. Optometrist Past Accepting new patients

Locations

5201 SE 14th St
Des Moines, IA 50320
Phone (515) 285-3568

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": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1619126307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14761 LAKEVIEW DR",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503257759",
            "telephone_number": "612-599-8327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 SE 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503201615",
            "telephone_number": "515-285-3568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3702 High Point Rd",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274074628",
            "country_code": "US",
            "telephone_number": "336-854-2020",
            "fax_number": "336-852-9472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUDAHN",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-17",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": "2108",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.