Individual provider Active NPI

Michael Edward Jonassen, O.D.

  • Optometrist
  • Hart, MI
National Provider Identifier
1922187673
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003163 Issued in MI
Practice address
44 S State St
Hart, MI 49420-1123
Phone
(231) 873-2575
Fax
(231) 873-2593
NPI assigned
Nov 3, 2006
Last updated
Feb 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003163 MI Primary

Addresses

Primary practice location

44 S State St
Hart, MI 49420-1123

Mailing address

44 S State St
Hart, MI 49420-1123
Phone (231) 873-2575

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
I20090619000080 MI Practitioner - Optometry 6608927314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

44 S State St
Hart, MI 49420-1123
Phone (231) 873-2575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3163MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Michael E Jonassen, O.D. P.C. Optometrist CurrentSince Jan 1, 1992 Accepting new patients
Rybarz Vision Associates, PLLC Optometrist PastSince May 16, 2009 Accepting new patients

Locations

44 S State St
Hart, MI 49420
Phone (231) 873-2575

Organizations & group practices 2

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1922187673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 S STATE ST",
            "city": "HART",
            "state": "MI",
            "postal_code": "494201123",
            "telephone_number": "231-873-2575",
            "fax_number": "231-873-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 S STATE ST",
            "city": "HART",
            "state": "MI",
            "postal_code": "494201123",
            "telephone_number": "231-873-2575",
            "fax_number": "231-873-2593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONASSEN",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hart, MI

Sources for this page

Verify at the official NPI Registry.