Individual provider Active NPI

Michael J McLane, O.D.

  • Optometrist
  • Orlando, FL
National Provider Identifier
1740271790
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC1489 Issued in FL
Practice address
2917 Edgewater Dr
Orlando, FL 32804-4413
Phone
(407) 834-7776
Fax
(407) 834-0973
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 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 OPC1489 FL Primary

Addresses

Primary practice location

2917 Edgewater Dr
Orlando, FL 32804-4413

Mailing address

160 Boston Ave
Altamonte Springs, FL 32701-4798
Phone (407) 834-7776

Other identifiers 1

IdentifierTypeStateIssuer
078269600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1489FLMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Eye Clinic P a Optometrist Past Accepting new patients
Florida Eye Clinic PA Optometrist Past Accepting new patients
Florida Eye Clinic P a Optometrist Past Accepting new patients

Organizations & group practices 3

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1740271790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BOSTON AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014798",
            "telephone_number": "407-834-7776",
            "fax_number": "407-834-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 EDGEWATER DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044413",
            "telephone_number": "407-834-7776",
            "fax_number": "407-834-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLANE",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078269600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.