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DR. MICHAEL R MONTGOMERY OD
NPI 1124002969
Optometrist in Lebanon, MO

Active since December 05, 2005PECOS EnrolledAccepts Medicare Assignment
279 E ELM ST, LEBANON, MO 65536(417) 532-2562(417) 532-2409 Get Directions Write a Review

NPPES record last updated: November 27, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Michael R Montgomery Od NPPES

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

DR. MICHAEL R MONTGOMERY OD (NPI 1124002969) is an individual optometrist in Lebanon, Missouri, licensed in Missouri (T02552) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (1983).

NPPES Registry Identity

NPI1124002969
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. MICHAEL R MONTGOMERYCredential: OD
Location Address279 E ELM STLebanon, MO 65536-3610
Mailing Address279 E Elm StLebanon, MO 65536-3610 · (417) 532-2562 · Fax (417) 532-2409
Phone(417) 532-2562
Fax(417) 532-2409
Sole ProprietorNo
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 1983
Enumeration DateDecember 5, 2005
Last NPPES UpdateNovember 27, 2012
✔ NPI 1124002969 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 MO · T02552
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.
279 E ELM ST, Lebanon, MO 65536
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Other Identifiers 7

Medicare UPINT42763
Other12603Spectera-lebanon Location
Medicaid312368319MO
Medicare PIN070425320MO
Medicare NSC0505630001MO
Other117102Bcbc-lebabon Location
Other117105Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health 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. Michael R Montgomery 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 ID244338309
PECOS Enrollment IDI20070615000442
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 Michael Montgomery reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Michael Montgomery Od PC
Same address
Ophthalmology
279 E ELM
Lebanon, MO 65536
  • Reassigned Medicare billing, Missouri enrollment
NPI 1316078868 (417) 532-2562

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 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.
100 services100 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
22 services21 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
19 services12 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.
16 services16 patients
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.
15 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65536 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
$121.96 typical visit price
range $52.28 – $161.24
Typical copayment $30.49 (range $13.07 – $40.31)
Most-billed visit code 99204
Established Patient
$65.71 typical visit price
range $16.30 – $131.05
Typical copayment $16.42 (range $4.07 – $32.76)
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.

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 Michael Montgomery's NPI number?

The NPI number for Michael Montgomery is 1124002969. It was assigned to this individual provider in the NPPES registry on December 5, 2005.

Where is Michael Montgomery located?

Michael Montgomery practices at 279 E Elm St, Lebanon, MO 65536. The listed phone number is (417) 532-2562.

What is Michael Montgomery's specialty?

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

Is Michael Montgomery enrolled in Medicare?

Yes. Michael Montgomery 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 Michael Montgomery's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Montgomery reassigns Medicare benefits to Michael Montgomery Od PC (Lebanon, MO). 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 Michael Montgomery's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Montgomery accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 14 other insurers list Michael Montgomery 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 Michael Montgomery was last updated on November 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.