Northern Eye Care Associates, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004595 Issued in MI

Legal business name

NORTHERN EYE CARE ASSOCIATES, P.C.

Practice address

200 Fairbanks St
Iron Mountain, MI 49801-1510

Phone

(906) 774-8280

Fax

(906) 774-8290

NPI assigned

Oct 27, 2011

Organization subpart

No

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

Authorized official

Name

Beau David Poquette, O.D.NPI 1649582586

Title

Optometrist

Phone

(906) 774-8280

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Beau David Poquette, O.D.

  • Optometrist
  • Iron Mountain, MI
  • NPI 1649582586
  Medicare reassignment Care Compare group NPD Authorized official
• Audry Lynn Poquette, O.D.

  • Optometrist
  • Iron Mountain, MI
  • NPI 1568742229
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479859200000",
    "number": "1699051193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FAIRBANKS ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498011510",
            "telephone_number": "906-774-8280",
            "fax_number": "906-774-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FAIRBANKS ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498011510",
            "telephone_number": "906-774-8280",
            "fax_number": "906-774-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN EYE CARE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-27",
        "last_updated": "2016-11-23",
        "status": "A",
        "authorized_official_last_name": "POQUETTE",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "906-774-8280",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0B20055",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMEPOS",
            "identifier": "6891720001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gene R Niec, PTA
• Sara Niven
• Kelly Sue Nordstrom, RPH
• Dakota Norman, CRNA
• Northern Eye Care Associates, P.C.
• Northern Lights Compounding Inc.
• Northern Michigan Home Health Inc
• Northern Optical, Inc.
• Northern Orthotics & Prosthetics
• Northern Pathology Laboratory, P.C.

• Optometrist in Iron Mountain, MI
• Providers in Iron Mountain, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.