Individual provider Active NPI

Michael Thomas Bywater, O.D.

  • Optometrist
  • Highland, NY
National Provider Identifier
1669441747
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV4980 Issued in NY
Practice address
216 Route 299
Suite 4
Highland, NY 12528-7517
Phone
(845) 691-8890
Fax
(845) 834-3224
NPI assigned
Mar 14, 2006
Last updated
Dec 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV4980 NY Primary

Addresses

Primary practice location

216 Route 299
Suite 4
Highland, NY 12528-7517

Mailing address

216 Route 299
Suite 4
Highland, NY 12528-7517
Phone (845) 691-8890

Other identifiers 1

IdentifierTypeStateIssuer
02745788MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060429000014 NY Practitioner - Optometry 3678583051 Practice locations: Highland, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

216 Route 299
Suite 4
Highland, NY 12528-7517
Phone (845) 691-8890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004980NYMDMental Health Counselor
TUV4980NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ayman Z. Matta, M.D., P.C. Past Accepting new patients
Hudson Valley Vision Center Inc. Optometrist PastSince Jan 22, 2018 Accepting new patients
Roy Kline Optometry PLLC Optometrist PastSince Oct 12, 2025 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1669441747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 ROUTE 299",
            "address_2": "SUITE 4",
            "city": "HIGHLAND",
            "state": "NY",
            "postal_code": "125287517",
            "telephone_number": "845-691-8890",
            "fax_number": "845-834-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 ROUTE 299",
            "address_2": "SUITE 4",
            "city": "HIGHLAND",
            "state": "NY",
            "postal_code": "125287517",
            "telephone_number": "845-691-8890",
            "fax_number": "845-834-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYWATER",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV4980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02745788",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, NY

Sources for this page

Verify at the official NPI Registry.