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DR. BLAZE SAMMON OD
NPI 1093442121
Optometrist in Iron Mountain, MI

Active since August 08, 2022PECOS EnrolledAccepts Medicare Assignment
W8159 S US HIGHWAY 2/141 STE 102, IRON MOUNTAIN, MI 49801(906) 779-9164(906) 774-5547 Get Directions Write a Review

NPPES record last updated: October 16, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Blaze Sammon Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BLAZE SAMMON OD (NPI 1093442121) is an individual optometrist in Iron Mountain, Michigan, licensed in Michigan (4901005661) and active in the NPI registry since August 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1093442121
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. BLAZE SAMMONCredential: OD
Location AddressW8159 S US HIGHWAY 2/141 STE 102Iron Mountain, MI 49801-9423
Mailing AddressW1974 Beaver Pete RdVulcan, MI 49892-8226 · (616) 710-9939
Phone(906) 779-9164
Fax(906) 774-5547
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateAugust 8, 2022
Last NPPES UpdateOctober 16, 2025
NPPES CertifiedOctober 16, 2025
✔ NPI 1093442121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in MI · 4901005661
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
W8159 S US HIGHWAY 2/141 STE 102, Iron Mountain, MI 49801
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross and Blue Shield of Louisiana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Blaze Sammon Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729443551
PECOS Enrollment IDI20231012001927
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Blaze Sammon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shoptikal LLC
Same address
Eyewear Supplier
W8159 S US HIGHWAY 2/141 STE 102
Iron Mountain, MI 49801
  • Reassigned Medicare billing, Michigan enrollment
  • 5 clinicians in this Medicare group
NPI 1831755255 (906) 779-9164

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
70 services68 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
40 services40 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
27 services25 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
14 services14 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49801 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHOPTIKAL LLC
Eyewear Supplier
W8159 S US HIGHWAY 2/141 STE 102
IRON MOUNTAIN, MI 49801
Dickinson County (906) 779-9164

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blaze Sammon's NPI number?

The NPI number for Blaze Sammon is 1093442121. It was assigned to this individual provider in the NPPES registry on August 8, 2022.

Where is Blaze Sammon located?

Blaze Sammon practices at W8159 S Us Highway 2/141 Ste 102, Iron Mountain, MI 49801. The listed phone number is (906) 779-9164.

What is Blaze Sammon's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Blaze Sammon enrolled in Medicare?

Yes. Blaze Sammon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Blaze Sammon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Blaze Sammon reassigns Medicare benefits to Shoptikal LLC (Iron Mountain, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Blaze Sammon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Blaze Sammon accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana and 5 other insurers list Blaze Sammon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Blaze Sammon was last updated on October 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.