Individual provider Active NPI

Michael Philip Sorensen, O.D

  • Optometrist
  • Kingwood, TX
National Provider Identifier
1891863551
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6106TG Issued in TX
Practice address
2818 Whispering Fern CT
Kingwood, TX 77345-2227
Phone
(832) 671-1265
Fax
(888) 818-2152
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6106TG TX Primary

Addresses

Primary practice location

2818 Whispering Fern CT
Kingwood, TX 77345-2227

Mailing address

2818 Whispering Fern CT
Kingwood, TX 77345-2227
Phone (832) 671-1265

Other identifiers 3

IdentifierTypeStateIssuer
1804833SFX01MedicaidTX
180483303MedicaidTX
180483302MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060125000364 TX Practitioner - Optometry 0749204071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2818 Whispering Fern CT
Kingwood, TX 77345-2227
Phone (888) 640-5155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6106TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Eye Care Associates Optometrist CurrentSince Dec 20, 2011 Accepting new patients
Mustapha Kibirige, MD, PA Optometrist Past Accepting new patients
Martha M Gallia OD PC PastSince May 16, 2001 Accepting new patients
Outreach Diagnostic Clinic Past Accepting new patients

Organizations & group practices 4

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1891863551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2818 WHISPERING FERN CT",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773452227",
            "telephone_number": "832-671-1265",
            "fax_number": "888-818-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2818 WHISPERING FERN CT",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773452227",
            "telephone_number": "832-671-1265",
            "fax_number": "888-818-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "MICHAEL",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6106TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1804833SFX01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180483303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180483302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.