Mic Optical Sourcing,Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MIC OPTICAL SOURCING,INC.

Practice address

2200 W Alameda Ave Unit 16
Denver, CO 80223-1947

Phone

(720) 238-2922

Fax

(720) 572-7999

NPI assigned

Dec 23, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Gang He, OPTICIANNPI 1518846047

Title

Owner

Phone

(720) 238-2922

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas J. Pethe, O.D.

  • Optometrist
  • Sioux Falls, SD
  • NPI 1265572762

  CO

  Medicare reassignment NPD
• Gang He, OPTICIAN

  • Optician
  • Denver, CO
  • NPI 1518846047
  NPD Authorized official

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756339200000",
    "number": "1851930879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W ALAMEDA AVE UNIT 16",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802231947",
            "telephone_number": "720-238-2922",
            "fax_number": "720-572-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W ALAMEDA AVE UNIT 16",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802231947",
            "telephone_number": "720-238-2922",
            "fax_number": "720-572-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIC OPTICAL SOURCING,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-23",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A",
        "authorized_official_last_name": "HE",
        "authorized_official_first_name": "GANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-238-2922",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole A Mezo, PA
• MH Super Systems LLC
• Mia Donley LLC
• Miaken L. Zeigler, D.C. Corp.
• Miaken L. Zeigler, D.C. Corp.
• Joy H Miccio, RN
• Carly Ann Micek
• Jane Frances Miceli, M.D.
• Michael a Snyder MD PC
• Michael a. Ament, M.D., PLLC

• Optometrist in Denver, CO
• Providers in Denver, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.