Individual provider Active NPI

Ryan J Brown, O.D.

  • Optometrist
  • Grand Rapids, MI
National Provider Identifier
1679802029
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004539 Issued in MI
Practice address
3019 Coit Ave NE
Grand Rapids, MI 49505-3376
Phone
(616) 365-7780
NPI assigned
Dec 14, 2009
Last updated
Dec 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004539 MI Primary

Addresses

Primary practice location

3019 Coit Ave NE
Grand Rapids, MI 49505-3376

Mailing address

3019 Coit Ave NE
Grand Rapids, MI 49505-3376
Phone (616) 365-7780

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100916000907 MI Practitioner - Optometry 4284759069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norway Eye Care P.C.Group PAC ID 2769424886, 3 clinicians

Practice addresses (Care Compare)

525 W Hwy U S 2
Norway, MI 49870-1127

525 W US Hwy 2
Norway, MI 49870-1127
Phone (906) 563-5711

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Norway Eye Care P.C. Optometrist CurrentSince Sep 1, 2010 Accepting new patients

Locations

525 W US Highway 2
Norway, MI 49870
Phone (906) 563-5711

Organizations & group practices 1

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": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1679802029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 COIT AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053376",
            "telephone_number": "616-365-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 COIT AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053376",
            "telephone_number": "616-365-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RYAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.