Bradley P Mundy, O.D.
Individual provider Active NPI Optometrist · Buchanan, MI
NPI 1942448675 · NPPES record last updated Mar 24, 2017
Key facts
- NPI
- 1942448675
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901004630 (MI)
- Practice address
- 400 E Front St
Ste a
Buchanan, MI 49107-1403 - Phone
- (269) 695-3434
- Fax
- (269) 695-2656
- NPI assigned
- Feb 3, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dr. Bradley P. Mundy, O.D., PLLC
Practice addresses (Care Compare)
400 E Front St a
Smoke Vision Care
Buchanan, MI 49107-1403
Phone (269) 695-3434
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 38 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110701000317 | MI | Practitioner - Optometry | 6305901463 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18003559 | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Bradley P. Mundy, O.D., PLLC | Optometrist | Current |
Accepting new patients |
| Northern Indiana Optometrists, PC | Optometrist | Past | Accepting new patients |
| DRS Steven and Brenda Smoke OD PC | Optometrist | Past | Accepting new patients |
| Christopher J. Wolf, OD, Inc | Optometrist | Past | Accepting new patients |
Locations
400 E Front St
Ste A
Buchanan, MI 49107
Phone (269) 695-3434
105 Pennsylvania Ave
Dowagiac, MI 49047
Phone (269) 782-7141
18301 US Highway 12
New Buffalo, MI 49117
Phone (269) 469-6331
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18003559 | IN | |
| Optometrist | 152W00000X | 4901004630 | MI | Yes |
Addresses
Primary practice location
400 E Front St
Ste a
Buchanan, MI 49107-1403
Mailing address
400 E Front St
Ste a
Buchanan, MI 49107-1403
Phone (269) 695-3434
Other providers in Buchanan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.