Kyle Scott Bates, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901005234 Issued in MI

Practice address

888 W Houghton Lake Dr
Prudenville, MI 48651-9451

Phone

(989) 366-7525

NPI assigned

Jun 3, 2019

Last updated

Jun 3, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Ferris State College - College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Lakeside Vision, Prudenville, PC

  • Optometrist
  • Prudenville, MI
  • NPI 1003557133
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1932767191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 W HOUGHTON LAKE DR",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "486519451",
            "telephone_number": "989-366-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 W HOUGHTON LAKE DR",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "486519451",
            "telephone_number": "989-366-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "KYLE",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ava Welch Baxter
• Holly C Beams
• Karalee Celeste Beemer
• Brittany Bevill

• Optometrist in Prudenville, MI
• Providers in Prudenville, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.