Individual provider Active NPI

Michael Kelly Gilbreath, O.D.

  • Optometrist
  • Kearney, NE
National Provider Identifier
1942438650
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1325 Issued in NE
Practice address
920 E 56TH St Ste D3
Kearney, NE 68847-8628
Phone
(308) 455-1283
Fax
(308) 455-1285
NPI assigned
Jul 1, 2009
Last updated
Apr 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1325 NE Primary

Addresses

Primary practice location

920 E 56TH St Ste D3
Kearney, NE 68847-8628

Mailing address

1104 E 56TH St Unit 4
Kearney, NE 68847-8615
Phone (402) 661-9033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20111024000526 NE Practitioner - Optometry 7012180870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

218 W 42ND St
Kearney, NE 68845-8500
Phone (308) 455-1283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1325NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Eye Care and Contact Lens Services, PC Optometrist CurrentSince Aug 1, 2011 Accepting new patients
Eyecare Associates Optometrist Past Accepting new patients

Locations

218 W 42nd St
Kearney, NE 68845
Phone (308) 237-9633

920 E 56th St
Ste D3
Kearney, NE 68847
Phone (308) 236-7471

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": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1942438650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 E 56TH ST UNIT 4",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478615",
            "telephone_number": "402-661-9033",
            "fax_number": "308-455-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E 56TH ST STE D3",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478628",
            "telephone_number": "308-455-1283",
            "fax_number": "308-455-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBREATH",
        "first_name": "MICHAEL",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.