Michael Montgomery Od Pc is a medicare enrolled "Ophthalmology" provider in Lebanon, Missouri. Their current practice location is
279 E Elm, Lebanon, Missouri. You can reach out to their office (for appointments etc.) via phone at
(417) 532-2562.
Michael Montgomery Od Pc is licensed to practice in Missouri (license number TO2552) and it also participates in the medicare program. Michael Montgomery Od Pc
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 1316078868.
Healthcare Provider's Profile
Full Name | Michael Montgomery Od Pc |
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Type | Facility |
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Speciality | Ophthalmology |
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Location | 279 E Elm, Lebanon, Missouri |
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Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1316078868
- Provider Enumeration Date: 03/08/2007
- Last Update Date: 03/14/2011
Medicare PECOS Information:
- PECOS PAC ID: 1355449414
- Enrollment ID: O20100623000380
Medical Identifiers
Medical identifiers for Michael Montgomery Od Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1316078868 | NPI | - | NPPES |
312368301 | Medicaid | MO | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
152W00000X | Optometrist | 2552 (Missouri) | Secondary |
332H00000X | Eyewear Supplier | 2552 (Missouri) | Secondary |
207W00000X | Ophthalmology | TO2552 (Missouri) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Michael Montgomery Od Pc acts as a billing entity for following providers:
Provider Name | Michael Montgomery |
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Provider Type | Practitioner - Optometry |
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Provider Identifiers | NPI Number: 1124002969 PECOS PAC ID: 0244338309 Enrollment ID: I20070615000442 |
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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 Montgomery Od Pc 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 Montgomery Od Pc Po Box 248, 279 East Elm, Lebanon, MO 65536-0248 Ph: (417) 532-2562 | Michael Montgomery Od Pc 279 E Elm, Lebanon, MO 65536 Ph: (417) 532-2562 |
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