Michael Walter Staron, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.007365 Issued in OH

Practice address

10620 Grandview Dr
Palos Park, IL 60464-2593

Phone

(708) 769-1557

NPI assigned

May 6, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Ohio State University - College of Optometry, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Florida Professional PLLCGroup PAC ID 3870960032, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Aeg Florida Professional PLLC

  • Optometrist
  • Jacksonville, FL
  • NPI 1164156246
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1619766516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 GRANDVIEW DR",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604642593",
            "telephone_number": "708-769-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 GRANDVIEW DR",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604642593",
            "telephone_number": "708-769-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARON",
        "first_name": "MICHAEL",
        "middle_name": "WALTER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-06",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6708",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blessing Short, PA-C
• Beena Valiaparampil Skaria, D.D.S.
• Brian G Smith, DMD
• Southwest Pediatrics, LTD.
• Stacy a Phelps LTD
• Dominick J Stella, M.D.
• Stevens Enterprises Inc.
• Patricia Stifter
• Mallory Clare Storrs, MBA, RD, LD
• Mariyan Kosev Stoykov

• Optometrist in Palos Park, IL
• Providers in Palos Park, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.