Peter J. Kurtz, OD

Individual provider Active NPI Optometrist · Menominee, MI

NPI 1750406450 · NPPES record last updated Aug 27, 2008

Key facts

NPI
1750406450
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
4901002914 (MI)
Practice address
801 1St St
Menominee, MI 49858-3231
Phone
(906) 863-2330
Fax
(906) 863-3794
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
Yes

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.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Medicare Care Compare profile

Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

801 1St St
Menominee, MI 49858-3231
Phone (906) 863-2330

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery39

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120808000483 MI Practitioner - Optometry 9234269580 Reassigns benefits to 1 organization
O20100930087950 MI DME Supplier - Physician - Optometrist 1951429356 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Menominee, MI

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Peter J. Kurtz, O.D., LLC Optometrist Current
since Aug 8, 2012
Accepting new patients

Locations

801 1st St
Menominee, MI 49858
Phone (906) 863-2330

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002914 MI Yes

Addresses

Primary practice location

801 1St St
Menominee, MI 49858-3231

Mailing address

801 1St St
Menominee, MI 49858-3231
Phone (906) 863-2330

Other identifiers

IdentifierTypeStateIssuer
5105883MedicaidMI
38523800MedicaidWI

Other providers in Menominee, MI

All providers in Menominee, MI · Optometrist in Michigan

Sources for this page

Verify at the official NPI Registry.