Individual provider Active NPI

Nathan Duane Gilmore, OD

  • Optometrist
  • Norton Shores, MI
National Provider Identifier
1902245202
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004757 Issued in MI
Practice address
951 Seminole Rd
Norton Shores, MI 49441-4341
Phone
(231) 780-4700
Fax
(231) 780-4722
NPI assigned
Jun 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004757 MI Primary

Addresses

Primary practice location

951 Seminole Rd
Norton Shores, MI 49441-4341

Mailing address

625 E Savidge St
Spring Lake, MI 49456-1956
Phone (616) 844-5650

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
I20130904000952 MI Practitioner - Optometry 8729221130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoreline Ophthalmology PLLCGroup PAC ID 3678537628, 14 clinicians

Practice addresses (Care Compare)

625 E Savidge St
Spring Lake, MI 49456-1956
Phone (616) 844-5650

Merit-based Incentive Payment System (MIPS)

Final score
80.4 of 100Reported as group
Quality
89.51
Promoting interoperability
100
Improvement activities
40
Cost
45.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Professional Eyecare PC Optometrist CurrentSince Jul 1, 2013 Accepting new patients
Shoreline Ophthalmology, PLLC CurrentSince Nov 30, 2015 Accepting new patients
Shoreline Optical, LLC Optometrist Past Accepting new patients

Locations

1401 W Main St
Ste 101
Fremont, MI 49412
Phone (231) 739-9009

22 W Main St
Fremont, MI 49412
Phone (231) 780-4700

1445 Sheldon Rd
Ste 100
Grand Haven, MI 49417
Phone (231) 739-9009

1266 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 737-4727

301 Center St
North Muskegon, MI 49445
Phone (231) 739-9009

3375 McCracken St
Norton Shores, MI 49441
Phone (231) 739-9009

951 Seminole Rd
Norton Shores, MI 49441
Phone (231) 780-4700

951 Seminole Rd
Ste 1
Norton Shores, MI 49441
Phone (231) 780-4700

625 E Savidge St
Spring Lake, MI 49456
Phone (616) 844-5650

Interoperability endpoints

  • Direct secure messaging: ngilmore@shorelinevision.imwdirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1902245202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E SAVIDGE ST",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494561956",
            "telephone_number": "616-844-5650",
            "fax_number": "616-844-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 SEMINOLE RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494414341",
            "telephone_number": "231-780-4700",
            "fax_number": "231-780-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "NATHAN",
        "middle_name": "DUANE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton Shores, MI

Sources for this page

Verify at the official NPI Registry.