Individual provider Active NPI

Samuel S Estes, O.D.

  • Optometrist
  • Lansing, MI
National Provider Identifier
1902895295
Registry record updated Jun 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
SE003722 Issued in MI
Practice address
2117 E Grand River Ave
Lansing, MI 48912-3231
Phone
(517) 485-2213
Fax
(517) 485-2220
NPI assigned
Oct 19, 2005
Last updated
Jun 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X SE003722 MI Primary

Addresses

Primary practice location

2117 E Grand River Ave
Lansing, MI 48912-3231

Mailing address

2117 E Grand River Ave
Lansing, MI 48912-3231
Phone (517) 485-2213

Other identifiers 2

IdentifierTypeStateIssuer
943120432MedicaidMI
900C36631OtherMIBCBS OF MICHIGAN

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
I20101004000630 MI Practitioner - Optometry 8022173061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1994
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)

2117 E Grand River Ave
Lansing, MI 48912-3231
Phone (517) 485-2220

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SE003722MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Sky Vision Eye Care, PC CurrentSince Jan 29, 2019 Accepting new patients
Blue Sky Vision Eye Care, P.C Optometrist CurrentSince Jan 29, 2019 Accepting new patients
Bennett Optometry LLC Optometrist Current Accepting new patients

Locations

350 Marshall St
Coldwater, MI 49036
Phone (517) 278-6303

750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 588-6506

112 S Clay St
Greenville, MI 48838
Phone (616) 754-5667

80 68th St SE
Kentwood, MI 49548
Phone (616) 391-8220

2117 E Grand River Ave
Lansing, MI 48912
Phone (517) 485-2213

706 S Centerville Rd
Sturgis, MI 49091
Phone (269) 241-2700

56847 N Main St
Three Rivers, MI 49093
Phone (269) 273-2020

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: samuel.estes.p1@direct.grophthalmology.nextgenshare.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, 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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277683200000",
    "number": "1902895295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 E GRAND RIVER AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123231",
            "telephone_number": "517-485-2213",
            "fax_number": "517-485-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 E GRAND RIVER AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123231",
            "telephone_number": "517-485-2213",
            "fax_number": "517-485-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTES",
        "first_name": "SAMUEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2010-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "SE003722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "943120432",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "900C36631",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.