Michael Paul Mucker, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG 001077 Issued in PA

Practice address

1513 Scalp Ave
Suite 280
Johnstown, PA 15904-3331

Phone

(814) 266-7611

Fax

(814) 266-3532

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Johnstown Family Vision & Hearing Inc

  • Optometrist
  • Johnstown, PA
  • NPI 1952487654
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1912970112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 SCALP AVE",
            "address_2": "SUITE 280",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043331",
            "telephone_number": "814-266-7611",
            "fax_number": "814-266-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 SCALP AVE",
            "address_2": "SUITE 280",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043331",
            "telephone_number": "814-266-7611",
            "fax_number": "814-266-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCKER",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG 001077",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "PA",
            "license": "OEG 001077",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014035000001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christos Ioannis Mouzakitis, MD
• Jessica Faye Moyer
• Mporess, LLC
• John K Mucciola, OD
• Robert Mucciola, MD
• Jude Arnold Mugerwa, MD
• Ivan Mulligan, PT, SCS, ATC
• Kara Mulvany
• Fredrick William Munzer, DO
• Bhaskaran Murali, M.D., F.A.C.S

• Optometrist in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.