Dale W Muth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003944 Issued in MI

Practice address

504 W Harrie St
Newberry, MI 49868-1200

Phone

(906) 293-9276

Fax

(906) 293-9100

NPI assigned

Aug 5, 2006

Last updated

Jun 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sault Tribe of Chippewa IndiansGroup PAC ID 7012982937, 29 clinicians

Dale W Muth OD PLLCGroup PAC ID 8325108780, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dale.muth@direct.revolutionehr.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.

• Dale W Muth OD PLLC

  • Optometrist
  • Newberry, MI
  • NPI 1255463162
  Medicare reassignment Care Compare group NPD Authorized official
• Sault Tribe of Chippewa Indians

  • Optometrist
  • Sault Sainte Marie, MI
  • NPI 1902074586
  Medicare reassignment Care Compare group NPD
• Dale W Muth OD PLLC

  • Eyewear Supplier
  • Newberry, MI
  • NPI 1629100011
  NPD (past) Authorized official
• Sault Tribe of Chippewa Indians

  • Family Nurse Practitioner
  • Sault Sainte Marie, MI
  • NPI 1205004884
  NPD
• Sault Tribe of Chippewa Indians

  dba Healing Place

  • Federally Qualified Health Center (FQHC)
  • Sault Sainte Marie, MI
  • NPI 1477389740
  NPD
• Sault Tribe of Chippewa Indians

  • Federally Qualified Health Center (FQHC)
  • Sault Sainte Marie, MI
  • NPI 1477721058
  NPD
• Sault Tribe of Chippewa Indians

  • Clinical Medical Laboratory
  • Sault Sainte Marie, MI
  • NPI 1750434395
  NPD
• Lakeshore Eye Clinic PC

  • Optometrist
  • Escanaba, MI
  • NPI 1265847073
  NPD (past)
• Norway Eye Care P.C.

  dba Norway Eye Care

  • Optometrist
  • Norway, MI
  • NPI 1134201601
  NPD (past)
• Paul R Gayeff OD PC

  • Optometrist
  • Escanaba, MI
  • NPI 1285767509
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1659380293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 W HARRIE ST",
            "city": "NEWBERRY",
            "state": "MI",
            "postal_code": "498681200",
            "telephone_number": "906-293-9276",
            "fax_number": "906-293-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 W HARRIE ST",
            "city": "NEWBERRY",
            "state": "MI",
            "postal_code": "498681200",
            "telephone_number": "906-293-9276",
            "fax_number": "906-293-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTH",
        "first_name": "DALE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425582194",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "900D800030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Magyar, LLMSW
• Latasha Martin, RN, BSN
• Danette Lynn Martyn, NURSE PRACTITIONER
• Stephanie Jo Metzler, CMT, MMT-P
• Cathy Ann Murphy, L.P.C.
• Daniel Netherton, PA-C
• Hilary S Newby, DDS
• Carol A Norman, CFNP
• Northern Light Solace, LLC
• Northern Star Chiropractic PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; 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.