Individual provider Active NPI

Michelle L Cote-Brzoza, OD

  • Optometrist
  • Gorham, ME
National Provider Identifier
1932107620
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
030-0000293 Issued in VT
Practice address
14 Vista Dr
Gorham, ME 04038-5882
Phone
(207) 389-3525
NPI assigned
Jul 7, 2005
Last updated
Jun 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 030-0000293 VT Primary

Addresses

Primary practice location

14 Vista Dr
Gorham, ME 04038-5882

Mailing address

14 Vista Dr
Gorham, ME 04038-5882

Other identifiers 1

IdentifierTypeStateIssuer
OVN2436MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20120413000662 VT Practitioner - Optometry 2860653011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Pincombe and WillisGroup PAC ID 5597987578, 3 clinicians
Maine Optometry PAGroup PAC ID 8022009117, 23 clinicians

Practice addresses (Care Compare)

1185 Shelburne Rd
Suite 5
South Burlington, VT 05403-7701
Phone (802) 862-0023

14 Vista Dr
Suite 200
Gorham, ME 04038-5884
Phone (207) 729-8474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030-0000293VTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pincombe & Willis Optometrist CurrentSince Jul 27, 2023 Accepting new patients

Locations

1185 Shelburne Rd
Ste 5
South Burlington, VT 05403
Phone (802) 862-0023

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1932107620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 VISTA DR",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040385882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 VISTA DR",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040385882",
            "telephone_number": "207-389-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTE-BRZOZA",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030-0000293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN2436",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gorham, ME

Sources for this page

Verify at the official NPI Registry.