Individual provider Active NPI

Jonathan Weston, O.D.

  • Corneal and Contact Management Optometrist
  • Ann Arbor, MI
National Provider Identifier
1891100392
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
4901004854 Issued in MI
Practice address
117 S Main St
Ann Arbor, MI 48104-1902
Phone
(734) 665-5306
NPI assigned
Jun 24, 2014
Last updated
May 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1986 AZ
Corneal and Contact Management Optometrist 152WC0802X 4901004854 MI Primary

Addresses

Primary practice location

117 S Main St
Ann Arbor, MI 48104-1902

Mailing address

8120 Gingko Way
Dexter, MI 48130-8437
Phone (586) 229-0579

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
I20150223000241 MI Practitioner - Optometry 7416173497 Reassigns benefits to 1 organization
Practice locations: Lake Orion, MI

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bennett Optometry LLCGroup PAC ID 5193719367, 17 clinicians

Practice addresses (Care Compare)

117 S Main St
Ann Arbor, MI 48104-1902
Phone (734) 665-5306

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901004854MIMDCorneal and Contact Management Optometrist
1986AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eyewear Detroit Company Optometrist CurrentSince Jul 1, 2017 Accepting new patients
Bennett Optometry LLC Optometrist Current Accepting new patients
Dr. Kenneth O'Daniel & Assoc., PC Optometrist PastSince Mar 29, 2017 Accepting new patients
Robert E. Deck, III O.D., PC Optometrist Past Accepting new patients
Lake Orion Vision PC Optometrist PastSince Aug 1, 2015 Accepting new patients

Locations

117 S Main St
Ann Arbor, MI 48104
Phone (734) 665-5306

48187 Van Dyke Ave
Shelby Township, MI 48317
Phone (586) 739-9550

Interoperability endpoints

  • Direct secure messaging: jonathanweston@direct.eyecare-partners.com

Organizations & group practices 5

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": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1891100392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 GINGKO WAY",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481308437",
            "telephone_number": "586-229-0579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S MAIN ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041902",
            "telephone_number": "734-665-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTON",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1986",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MI",
            "license": "4901004854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.