Michael James Bangert, MICHAEL BANGERT, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18001776B Issued in IN

Practice address

4626 W Jefferson Blvd
Fort Wayne, IN 46804-6826

Phone

(260) 432-5502

Fax

(260) 432-8415

NPI assigned

Jan 26, 2007

Last updated

Jul 30, 2013By 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 names 1

• Dr. Michael James Bangert Other name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Apple Eyecare FW Southwest LLC

  dba Apple Eyecare

  • Optometrist
  • Fort Wayne, IN
  • NPI 1285375014
  Medicare reassignment NPD
• Michael J. Bangert O.D. Inc.

  dba Family EyeCare Associates

  • Optometrist
  • Fort Wayne, IN
  • NPI 1689720054
  Authorized official Same address or phone

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1629124151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046826",
            "telephone_number": "260-432-5502",
            "fax_number": "260-432-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046826",
            "telephone_number": "260-432-5502",
            "fax_number": "260-432-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGERT",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MICHAEL BANGERT, OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001776B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "BANGERT",
            "middle_name": "JAMES",
            "prefix": "DR.",
            "credential": "MICHAEL BANGERT O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bandaidsplus, LLC
• Stephanie R Bandy, DPT, ATC
• Tabitha J Bane
• Ashley Baney
• Jill A. Baney, NP
• Gregory M. Banicki, M.S. ED.
• Maegan Banicki
• Jakyria Monae-Tyree Banks
• Regan J Banks, MS ED
• Amanjit Kaur Banwait

• Optometrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.