Michael Lee Stark, DO is a medicare enrolled "Ophthalmology" physician in Sidney, Ohio. His current practice location is
1118 Fairington Dr, Sidney, Ohio. You can reach out to his office (for appointments etc.) via phone at
(937) 492-3755.
Michael Lee Stark is licensed to practice in Ohio (license number 3380) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1679579577.
Physician's Profile
| Full Name | Michael Lee Stark |
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| Gender | Male |
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| Speciality | Ophthalmology |
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| Location | 1118 Fairington Dr, Sidney, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1679579577
- Provider Enumeration Date: 06/24/2005
- Last Update Date: 09/16/2020
Medicare PECOS Information:
- PECOS PAC ID: 7214830611
- Enrollment ID: I20040202000618
Medical Identifiers
Medical identifiers for Michael Lee Stark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679579577 | NPI | - | NPPES |
| 0533462 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207W00000X | Ophthalmology | 3380 (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Michael Lee Stark allows following entities to bill medicare on his behalf.
| Entity Name | Cei Physicians Psc, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942296298
PECOS PAC ID: 0749186427
Enrollment ID: O20031211001059 |
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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. Michael Lee Stark 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 |
|---|
Michael Lee Stark, DO
4445 Lake Forest Dr Ste 600,
Blue Ash, OH 45242-3744
Ph: (513) 569-3741 | Michael Lee Stark, DO
1118 Fairington Dr,
Sidney, OH 45365-8913
Ph: (937) 492-3755 |
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