Individual provider Active NPI

Michael S Engleman, O.D.

  • Optometrist
  • Springfield, MO
National Provider Identifier
1790754109
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02775 Issued in MO
Practice address
1265 E Primrose St
Springfield, MO 65804-4278
Phone
(417) 886-3937
Fax
(417) 886-1285
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02775 MO Primary

Addresses

Primary practice location

1265 E Primrose St
Springfield, MO 65804-4278

Mailing address

1265 E Primrose St
Springfield, MO 65804-4278
Phone (417) 886-3937

Other identifiers 1

IdentifierTypeStateIssuer
316901305MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mse@mnp1999.integrityemrdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000611 MO Practitioner - Optometry 2062540032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mattax Neu Prater Eye Center IncGroup PAC ID 6103713979, 13 clinicians

Practice addresses (Care Compare)

1265 E Primrose St
Springfield, MO 65804-4278
Phone 41788639371166

168 S Payne Stewart Dr
Suite 200
Branson, MO 65616-2717
Phone (417) 348-1111

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as group
Quality
95
Improvement activities
40
Cost
77.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T02775MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mattax Neu Prater Eye Center, Inc. Optometrist CurrentSince Nov 21, 2018 Accepting new patients

Locations

168 S Payne Stewart Dr
Ste 200
Branson, MO 65616
Phone (417) 348-1111

2170 E Cleveland St
Monett, MO 65708
Phone (417) 235-0853

1265 E Primrose St
Springfield, MO 65804
Phone (417) 886-3937

Interoperability endpoints

  • Direct secure messaging: mengleman@mnpeyecenter.direct.eyemdemr.com

Organizations & group practices 2

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1790754109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 E PRIMROSE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044278",
            "telephone_number": "417-886-3937",
            "fax_number": "417-886-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 E PRIMROSE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044278",
            "telephone_number": "417-886-3937",
            "fax_number": "417-886-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLEMAN",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316901305",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mse@mnp1999.integrityemrdirect.com",
            "affiliation": "N",
            "address_1": "1265 E Primrose St",
            "city": "Springfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "658044278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.