Individual provider Active NPI

Michael S McAvoy, OD

  • Optometrist
  • Southington, CT
National Provider Identifier
1851471577
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1094 Issued in CT
Practice address
235 Queen St
Southington, CT 06489-1915
Phone
(860) 628-4711
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1094 CT Primary

Addresses

Primary practice location

235 Queen St
Southington, CT 06489-1915

Mailing address

45 Bunker Hill
Canton, CT 06019
Phone (860) 693-8088

Other identifiers 1

IdentifierTypeStateIssuer
004162301MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20101123000820 CT Practitioner - Optometry 4981726643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

72 Queen St
Southington, CT 06489-2056
Phone (860) 628-4711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Accu Vision Center, Inc Optometrist CurrentSince Feb 17, 1995 Accepting new patients

Locations

72 Queen St
Southington, CT 06489
Phone (860) 628-4711

235 Queen St
Southington, CT 06489
Phone (860) 621-2310

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1851471577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 BUNKER HILL",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "06019",
            "telephone_number": "860-693-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 QUEEN ST",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891915",
            "telephone_number": "860-628-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCAVOY",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "1094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004162301",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

Verify at the official NPI Registry.