Amanda Lyn Johnston, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004438 Issued in MI

Practice address

120 Paluster St
Cadillac, MI 49601-2532

Phone

(231) 775-7341

Fax

(231) 775-3925

NPI assigned

Jul 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Ferris State College - College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Optometry, P.L.L.C.Group PAC ID 8325130321, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Advanced Optometry, P.L.L.C.

  • Optometrist
  • Cadillac, MI
  • NPI 1578535126
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1699974477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PALUSTER ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012532",
            "telephone_number": "231-775-7341",
            "fax_number": "231-775-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PALUSTER ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012532",
            "telephone_number": "231-775-7341",
            "fax_number": "231-775-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "AMANDA",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Johnson, PHARM D STUDENT
• Sara Beth Johnson, LLBSW
• Timothy Allen Johnson, M.D.
• Wesley Johnson, LPC
• Zachary Johnson, DPT
• Shelby Jones-Stachnik, TLLP
• Hannah Marie Jones, PT, DPT
• Jose P Dela Rosa MD
• Joseph T Trubiroha OD LLC
• Stacey Marie Hiltz Kaminski, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.