Individual provider Active NPI

Michael W Brumit, O.D.

  • Optometrist
  • Charlestown, IN
National Provider Identifier
1871629592
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002086AB Issued in IN
Practice address
954 Market St
Charlestown, IN 47111-1951
Phone
(812) 256-6321
Fax
(812) 256-6837
NPI assigned
Feb 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 18002086AB IN Primary

Addresses

Primary practice location

954 Market St
Charlestown, IN 47111-1951

Mailing address

PO Box 307
Charlestown, IN 47111-0307
Phone (812) 256-6321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20120119000084 IN Practitioner - Optometry 3173790953 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002086ABINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
First Impressions Optometric Associates, LLC Optometrist CurrentSince Feb 6, 2022 Accepting new patients
First Impressions Optometric Associates, LLC Optometrist CurrentSince Feb 6, 2022 Accepting new patients
Ky Doctors of Optometry, PLLC Optometrist Past Accepting new patients

Locations

1030 Veterans Pkwy
Clarksville, IN 47129
Phone (812) 282-2020

800 N Green River Rd
Spc 205
Evansville, IN 47715
Phone (812) 475-1946

2141 Sagamore Pkwy S
Lafayette, IN 47905
Phone (765) 446-8010

Organizations & group practices 3

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871629592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471110307",
            "telephone_number": "812-256-6321",
            "fax_number": "812-256-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 MARKET ST",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471111951",
            "telephone_number": "812-256-6321",
            "fax_number": "812-256-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMIT",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002086AB",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlestown, IN

Sources for this page

Verify at the official NPI Registry.