Active NPI
Mike Bain
- Ocularist
- Saginaw, MI
National Provider Identifier
1912086281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ocularist
- License
- MB000027
- Practice address
- 5161 Cardinal Park Drive
Saginaw, MI 48604-9435 - Phone
- (989) 797-2400
- Fax
- (989) 249-1035
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ocularist | 156FX1700X | MB000027 | MI | Primary |
Addresses
Primary practice location
5161 Cardinal Park Drive
Saginaw, MI 48604-9435
Mailing address
PO Box 5649
Saginaw, MI 48603-0649
Phone (989) 797-2400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4296145 | Medicaid | MI | |
| MB000027 | Other | MI | STATE LICENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MB000027 | MI | MD | Ocularist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Andersen Eye Prosthetics LLC | Ocularist | Past | Accepting new patients |
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": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302480000000",
"number": "1912086281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5649",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486030649",
"telephone_number": "989-797-2400",
"fax_number": "989-249-1035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5161 CARDINAL PARK DRIVE",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486049435",
"telephone_number": "989-797-2400",
"fax_number": "989-249-1035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAIN",
"first_name": "MIKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2011-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1700X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ocularist",
"state": "MI",
"license": "MB000027",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4296145",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENCE",
"identifier": "MB000027",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saginaw, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.