Individual provider Active NPI

Joseph Anthony Montana, OD

  • Optometrist
  • Lincoln Park, MI
National Provider Identifier
1932141934
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002981 Issued in MI
Practice address
1755 Dix Hwy
Lincoln Park, MI 48146-1412
Phone
(313) 382-9650
Fax
(313) 382-3428
NPI assigned
Jun 12, 2006
Last updated
Aug 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002981 MI Primary

Addresses

Primary practice location

1755 Dix Hwy
Lincoln Park, MI 48146-1412

Mailing address

47303 Dove CT
Shelby Township, MI 48315-4835
Phone (313) 382-9650

Other identifiers 1

IdentifierTypeStateIssuer
941785388MedicaidMI

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
I20100714000619 MI Practitioner - Optometry 2264560523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onsight IncGroup PAC ID 6507938800, 27 clinicians

Practice addresses (Care Compare)

601 Abbot Rd
East Lansing, MI 48823-3366
Phone 24852821166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Onsight, Inc. CurrentSince Oct 3, 2024 Accepting new patients
Onsight, Inc. CurrentSince Oct 3, 2024 Accepting new patients
Onsight, Inc. Current Accepting new patients
Giaimo Mobile Podiatry of WV PLLC Past Accepting new patients
Eye Institute of South Eastern Michigan Optometrist PastSince Sep 10, 2022 Accepting new patients
Onsight, Inc. Optometrist Past Accepting new patients

Locations

2567 W Grand Blvd
Detroit, MI 48208
Phone (313) 895-2990

601 Abbott Rd
East Lansing, MI 48823
Phone 24852821166

1200 Kirts Blvd
Ste 200
Troy, MI 48084
Phone 24852819814031

Organizations & group practices 6

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1932141934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47303 DOVE CT",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154835",
            "telephone_number": "313-382-9650",
            "fax_number": "313-382-3428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 DIX HWY",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481461412",
            "telephone_number": "313-382-9650",
            "fax_number": "313-382-3428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTANA",
        "first_name": "JOSEPH",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "941785388",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln Park, MI

Sources for this page

Verify at the official NPI Registry.