Michael Bifano
Individual provider Active NPI Optometrist · Southaven, MS
NPI 1730923707 · NPPES record last updated Aug 19, 2025
Key facts
- NPI
- 1730923707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1094 (MS)
- Practice address
- 726 Goodman Rd E Ste B
Southaven, MS 38671-9530 - Phone
- (662) 349-1959
- Fax
- (662) 510-2391
- NPI assigned
- Jun 24, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Desoto Eyecare Inc
Practice addresses (Care Compare)
726 Goodman Rd E
Suite B
Southaven, MS 38671-9530
Phone (662) 349-1959
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240814001800 | MS | Practitioner - Optometry | 8325586928 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1094 | MS | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desoto Eyecare Inc | Current |
Accepting new patients |
Locations
7164 Hacks Cross Rd
Ste 126
Olive Branch, MS 38654
Phone (662) 895-3937
726 Goodman Rd E
#B
Southaven, MS 38671
Phone (662) 349-1959
726 Goodman Rd E
Southaven, MS 38671
Phone (662) 349-1959
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Optometrist | 152W00000X | 1094 | MS | Yes |
Addresses
Primary practice location
726 Goodman Rd E Ste B
Southaven, MS 38671-9530
Mailing address
726 Goodman Rd E Ste B
Southaven, MS 38671-9530
Phone (662) 349-1959
Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.