Vision Source Kingsford is a medicare enrolled "Optometrist" provider in Kingsford, Michigan. Their current practice location is
401 Woodward Ave, Kingsford, Michigan. You can reach out to their office (for appointments etc.) via phone at
(906) 774-0611.
Vision Source Kingsford is licensed to practice in Michigan (license number 4901003162) and it also participates in the medicare program. Vision Source Kingsford
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1407077290.
Healthcare Provider's Profile
| Full Name | Vision Source Kingsford |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 401 Woodward Ave, Kingsford, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1407077290
- Provider Enumeration Date: 05/01/2007
- Last Update Date: 12/02/2008
Medicare PECOS Information:
- PECOS PAC ID: 2264515089
- Enrollment ID: O20080215000570
Medical Identifiers
Medical identifiers for Vision Source Kingsford such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407077290 | NPI | - | NPPES |
| 38578900 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 4901003162 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Vision Source Kingsford acts as a billing entity for following providers:
| Provider Name | Nelson Howard Hassell |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1689771487
PECOS PAC ID: 7719060532
Enrollment ID: I20080215000566 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Vision Source Kingsford is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Vision Source Kingsford
401 Woodward Ave,
Kingsford, MI 49802-4630
Ph: (906) 774-0611 | Vision Source Kingsford
401 Woodward Ave,
Kingsford, MI 49802-4630
Ph: (906) 774-0611 |
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