Individual provider Active NPI

Annessa M Dix, OD

  • Optometrist
  • Grand Rapids, MI
National Provider Identifier
1720167323
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AD000806 Issued in MI
Practice address
750 E Beltline Ave NE
Grand Rapids, MI 49525-6049
Phone
(616) 949-2600
NPI assigned
Nov 3, 2006
Last updated
Oct 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X AD000806 MI Primary

Addresses

Primary practice location

750 E Beltline Ave NE
Grand Rapids, MI 49525-6049

Mailing address

750 E Beltline Ave NE
Grand Rapids, MI 49525-6049
Phone (616) 949-2600

Other names 1

  • Mrs. Annessa M Allison Other 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
I20051107000033 MI Practitioner - Optometry 7618995887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Sky Vision Eye Care PCGroup PAC ID 8820065618, 51 clinicians

Practice addresses (Care Compare)

3300 Walker VW NW
Walker, MI 49544-9139
Phone (616) 949-2600

750 E Beltline Ave NE
Grand Rapids, MI 49525-6049
Phone (616) 588-6506

Merit-based Incentive Payment System (MIPS)

Final score
75.03 of 100Reported as group
Quality
85.46
Promoting interoperability
100
Improvement activities
40
Cost
31.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AD000806MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gro Optical, LLC Past Accepting new patients
Grand Rapids Eye Institute, PLC Optometrist Past Accepting new patients
Eye Center of Lenawee P.C. Optometrist PastSince Sep 5, 2000 Accepting new patients
DRS. Ravin, Birndorf & Ravin, Inc. Optometrist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: annessa.dix.p1@direct.grophthalmology.nextgenshare.com

Organizations & group practices 5

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1720167323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256049",
            "telephone_number": "616-949-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256049",
            "telephone_number": "616-949-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIX",
        "first_name": "ANNESSA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "AD000806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNESSA",
            "last_name": "ALLISON",
            "middle_name": "M",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.