Individual provider Active NPI

Danielle Marie Mayne, OD

  • Optometrist
  • Ann Arbor, MI
National Provider Identifier
1689103244
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005045 Issued in MI
Practice address
117 S Main St
Ann Arbor, MI 48104-1902
Phone
(734) 665-5306
Fax
(734) 665-5522
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005045 MI Primary

Addresses

Primary practice location

117 S Main St
Ann Arbor, MI 48104-1902

Mailing address

PO Box 208177
Dallas, TX 75320-8177
Phone (636) 200-4393

Other practice location 1

2877 Crooks Rd Ste B
Troy, MI 48084-4717
Phone (248) 822-7003

Other names 1

  • Danielle Marie Machuta Former name

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
I20170724003257 MI Practitioner - Optometry 4385914340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mei Operations, PLLCGroup PAC ID 2860436318, 17 clinicians

Practice addresses (Care Compare)

4499 Town Ctr Pkwy
Flint, MI 48532-3425
Phone (810) 733-7111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mei Operations, PLLC CurrentSince Nov 22, 2021 Accepting new patients
Mid Michigan Eye Care Center, PC Optometrist Past Accepting new patients

Locations

16255 Silver Pkwy
Fenton, MI 48430
Phone (810) 629-7900

4499 Town Center Pkwy
Flint, MI 48532
Phone (810) 733-7111

8275 Holly Rd
Ste 3
Grand Blanc, MI 48439
Phone (810) 694-8400

1240 S Lapeer Rd
Ste 100A
Lake Orion, MI 48360
Phone (248) 236-9379

1005 S Lapeer Rd
Lapeer, MI 48446
Phone (810) 664-5458

432 W University Dr
Rochester, MI 48307
Phone (248) 651-6122

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1689103244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208177",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753208177",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S MAIN ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041902",
            "telephone_number": "734-665-5306",
            "fax_number": "734-665-5522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2877 Crooks Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480844717",
            "country_code": "US",
            "telephone_number": "248-822-7003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNE",
        "first_name": "DANIELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "MACHUTA",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.