Michael Lee Fogt, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC980 Issued in FL

Practice address

900 SE Ocean Blvd
Suite 106a
Stuart, FL 34994-2471

Phone

(772) 287-2663

Fax

(772) 781-6797

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1730172073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 SE OCEAN BLVD",
            "address_2": "SUITE 106A",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942471",
            "telephone_number": "772-287-2663",
            "fax_number": "772-781-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SE OCEAN BLVD",
            "address_2": "SUITE 106A",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942471",
            "telephone_number": "772-287-2663",
            "fax_number": "772-781-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGT",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4875080001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florida Vision Optique, Inc.
• Florida Woman Care, LLC
• Hailey M Flott
• Madison Floyd
• Miriam Elizabeth Floyd
• Katelyn Alyse Foley
• Patrick H. Foley, M.D.
• Robert Donald Follweiler, D.D.S.
• Richard Oswald Follwell, D.O.
• Jacqueline Fonseca Vallejo

• Optometrist in Stuart, FL
• Providers in Stuart, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.