Individual provider Active NPI

Russel F Curtis, OD

  • Optometrist
  • Byron Center, MI
National Provider Identifier
1871550525
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002997 Issued in MI
Practice address
2155 84TH St SW
Byron Center, MI 49315
Phone
(616) 878-3600
Fax
(616) 878-7098
NPI assigned
Apr 27, 2006
Last updated
Aug 14, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002997 MI Primary

Addresses

Primary practice location

2155 84TH St SW
Byron Center, MI 49315

Mailing address

2155 84TH St SW
Byron Center, MI 49315
Phone (616) 878-3600

Other identifiers 1

IdentifierTypeStateIssuer
RC002997OtherMIBCBS OF MI PIN

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
I20040401000545 MI Practitioner - Optometry 6709778178 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901002997MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Curtis Eyecare, PC Optometrist CurrentSince May 25, 1985 Accepting new patients

Locations

2155 84th St SW
Byron Center, MI 49315
Phone (616) 878-3600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1871550525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 84TH ST SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "49315",
            "telephone_number": "616-878-3600",
            "fax_number": "616-878-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 84TH ST SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "49315",
            "telephone_number": "616-878-3600",
            "fax_number": "616-878-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CURTIS",
        "first_name": "RUSSEL",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI PIN",
            "identifier": "RC002997",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Byron Center, MI

Sources for this page

Verify at the official NPI Registry.