Individual provider Active NPI

Brett Arnold, O.D.

  • Optometrist
  • Ann Arbor, MI
National Provider Identifier
1821404955
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004851 Issued in MI
Practice address
1565 Eastover Place
Ann Arbor, MI 48104
Phone
(734) 759-2909
Fax
(734) 929-4142
NPI assigned
Jul 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004851 MI Primary

Addresses

Primary practice location

1565 Eastover Place
Ann Arbor, MI 48104

Mailing address

1565 Eastover Place
Ann Arbor, MI 48104
Phone (734) 759-2909

Other identifiers 1

IdentifierTypeStateIssuer
4901004851OtherMIMICHIGAN OPTOMETRY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140805002672 MI Practitioner - Optometry 3476770009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Michigan Professional LLCGroup PAC ID 7113395864, 23 clinicians

Practice addresses (Care Compare)

32415 5 Mile Rd
Livonia, MI 48154-3039
Phone (734) 525-8170

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Michigan Professional LLC Optometrist CurrentSince Dec 7, 2022 Accepting new patients

Locations

32415 5 Mile Rd
Livonia, MI 48154
Phone (734) 525-8170

123 S Shiawassee St
Owosso, MI 48867
Phone (989) 725-8422

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1821404955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 EASTOVER PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-759-2909",
            "fax_number": "734-929-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 EASTOVER PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-759-2909",
            "fax_number": "734-929-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "BRETT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-09",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN OPTOMETRY LICENSE",
            "identifier": "4901004851",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.