Individual provider Active NPI

Richard Lee McDonald, O.D.

  • Optometrist
  • Cadillac, MI
National Provider Identifier
1891783163
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004018 Issued in MI
Practice address
120 Paluster St
Cadillac, MI 49601-2532
Phone
(231) 775-7341
Fax
(231) 775-3925
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004018 MI Primary

Addresses

Primary practice location

120 Paluster St
Cadillac, MI 49601-2532

Mailing address

120 Paluster St
Cadillac, MI 49601-2532
Phone (231) 775-7341

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
I20110805000737 MI Practitioner - Optometry 2860584877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Optometry, P.L.L.C.Group PAC ID 8325130321, 3 clinicians

Practice addresses (Care Compare)

120 Paluster St
Cadillac, MI 49601-2532
Phone (231) 775-7341

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901004018MIMDOptometrist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1891783163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PALUSTER ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012532",
            "telephone_number": "231-775-7341",
            "fax_number": "231-775-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PALUSTER ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012532",
            "telephone_number": "231-775-7341",
            "fax_number": "231-775-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

Verify at the official NPI Registry.