Active NPI
Scott James Moore, O.D.
- Optometrist
- Burton, MI
National Provider Identifier
1730177122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901004271
- Practice address
- 1235 S Center Rd
Suite 16
Burton, MI 48509-1700 - Phone
- (810) 744-1950
- Fax
- (810) 744-1515
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901004271 | MI | Primary |
Addresses
Primary practice location
1235 S Center Rd
Suite 16
Burton, MI 48509-1700
Mailing address
1235 S Center Rd
Suite 16
Burton, MI 48509-1700
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
Enrollment records 1
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
Practice addresses (Care Compare)
1235 S Ctr Rd
Suite 16
Burton, MI 48509-1700
Phone (810) 744-1950
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901004271 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General Optical Company | Optometrist | Current | Accepting new patients |
Locations
1235 S Center Rd
Ste 16
Burton, MI 48509
Phone (810) 744-1950
3140 W Silver Lake Rd
Fenton, MI 48430
Phone (810) 593-1000
523 M L King Ave
Flint, MI 48502
Phone (810) 238-0925
Organizations & group practices 1
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": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204761600000",
"number": "1730177122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1235 S CENTER RD",
"address_2": "SUITE 16",
"city": "BURTON",
"state": "MI",
"postal_code": "485091700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 S CENTER RD",
"address_2": "SUITE 16",
"city": "BURTON",
"state": "MI",
"postal_code": "485091700",
"telephone_number": "810-744-1950",
"fax_number": "810-744-1515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "SCOTT",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2008-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901004271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.