Michael John Gorz, OD
Individual provider Active NPI Optometrist · Algoma, WI
NPI 1750867149 · NPPES record last updated Jul 18, 2018
Key facts
- NPI
- 1750867149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 3514-35 (WI)
- Practice address
- 1021 Jefferson St
Algoma, WI 54201-1737 - Phone
- (920) 487-2020
- NPI assigned
- Jul 18, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lakeshore Vision Centers, LTD
Practice addresses (Care Compare)
1021 Jefferson St
Algoma, WI 54201-1737
Phone (920) 487-2020
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 22 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- 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 |
|---|---|---|---|---|
| I20180809000003 | WI | Practitioner - Optometry | 7214285170 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeshore Vision Centers, LTD | Current |
Accepting new patients |
Locations
1021 Jefferson St
Algoma, WI 54201
Phone (920) 487-2020
1217 Ellis St
Kewaunee, WI 54216
Phone (877) 462-9465
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3514-35 | WI | Yes |
Addresses
Primary practice location
1021 Jefferson St
Algoma, WI 54201-1737
Mailing address
1021 Jefferson St
Algoma, WI 54201-1737
Phone (920) 487-2020
Other practice location 1
1217 Ellis St
Kewaunee, WI 54216-1825
Phone (920) 388-2020
Other providers in Algoma, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2018. 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.