Active NPI
Mikaela Liem Callahan, OD
- Optometrist
- Bradenton, FL
National Provider Identifier
1972397222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT8304
- Practice address
- 5520 FL-64 #101
Bradenton, FL 34208 - Phone
- (941) 721-0649
- NPI assigned
- Apr 9, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT8304 | MA | Primary |
Addresses
Primary practice location
5520 FL-64 #101
Bradenton, FL 34208
Mailing address
1662 Commonwealth Ave Apt 34
Brighton, MA 02135-5609
Phone (617) 266-2030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT8304 | MA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758758400000",
"number": "1972397222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1662 COMMONWEALTH AVE APT 34",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021355609",
"telephone_number": "617-266-2030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5520 FL-64 #101",
"city": "BRADENTON",
"state": "FL",
"postal_code": "34208",
"telephone_number": "941-721-0649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLAHAN",
"first_name": "MIKAELA",
"middle_name": "LIEM",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-09",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "OPT8304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.