Scott Richard Ecenbarger, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004003 Issued in MI

Practice address

5751 Byron Center Ave SW
Suite V
Wyoming, MI 49519-9621

Phone

(616) 532-2020

Fax

(616) 532-2022

NPI assigned

Jun 9, 2006

Last updated

May 19, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Ferris State College - College of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ecenbarger Eye Care, LLCGroup PAC ID 4284634122, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: direct@ecenbargereyecarellcwyomingmi.compulinkdirect.com

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.

• Ecenbarger Eye Care, LLC

  • Optometrist
  • Wyoming, MI
  • NPI 1609959089
  Medicare reassignment Care Compare group Authorized official
• Wyoming Family Vision Care LLC

  dba Wyoming Family Vision Care

  • Optometrist
  • Wyoming, MI
  • NPI 1730583972
  NPD (past)
• Wyoming Family Vision Care PLLC

  • Optometrist
  • Wyoming, MI
  • NPI 1922206531
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1629019914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 BYRON CENTER AVE SW",
            "address_2": "SUITE V",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199621",
            "telephone_number": "616-532-2020",
            "fax_number": "616-532-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 BYRON CENTER AVE SW",
            "address_2": "SUITE V",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199621",
            "telephone_number": "616-532-2020",
            "fax_number": "616-532-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECENBARGER",
        "first_name": "SCOTT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94-4712563",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Dykwell, RN
• Brooke A Dylenski, NP
• Silvia Cristina Dyson, LMSW, LCSW
• Ross Allen Eardley, PHARMD, BCPS
• Ecenbarger Eye Care, LLC
• Staci Dawn Ecenbarger, O.D.
• Eda Leach
• Allison Leigh Edberg, D.O.
• Eden Homecare LLC
• Taylor Edgecomb

• Optometrist in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.