Michelle Lauren Zickel Blew, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG002586 Issued in PA

Practice address

183 Port Rd Ste B
Kennebunk, ME 04043-7735

Phone

(207) 216-9937

Fax

(207) 216-9939

NPI assigned

Jul 8, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other names 1

• Michelle Lauren Zickel Former name

Medicare fee-for-service enrollment

Enrolled in ME

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Michelle Blew, O.D., LLC

  • Optometrist
  • Kennebunk, ME
  • NPI 1568284578

  ME, Optometrist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1891007688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 PORT RD STE B",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040437735",
            "telephone_number": "207-216-9937",
            "fax_number": "207-216-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 PORT RD STE B",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040437735",
            "telephone_number": "207-216-9937",
            "fax_number": "207-216-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEW",
        "first_name": "MICHELLE",
        "middle_name": "LAUREN ZICKEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ME",
            "license": "1048",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010377",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4902",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "1048",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "ZICKEL",
            "middle_name": "LAUREN",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sharon G Berliner, LCSW
• Joseph Berry, M.A., SLP
• Kristine Bertini, PSYD
• Marianne Cayes Berube, LCSW
• Regan Kay Blanchard
• Emma Riley Blomstrom, PT, DPT
• Arianna Genevieve Bogucki, RD
• Gage August Bollinger, DO
• Donna Margaret Bolstridge, RN
• Brandon Kyle Bourgoin, DPT

• All providers in Kennebunk, ME
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.