DR. MICHAEL A. FISHBAUGH JR. O.D.
NPI 1225036197
Optometrist in St. Henry, OH

Q: What is Michael Fishbaugh's NPI number?

The NPI number for Michael Fishbaugh is 1225036197. It was assigned to this individual provider in the NPPES registry on July 13, 2005.

Q: What is Michael Fishbaugh's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Michael Fishbaugh was last updated on December 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since July 13, 2005PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

570 KREMER HOYING RD., SUITE F, ST. HENRY, OH 45883(419) 678-8800(419) 678-4224 Get Directions Write a Review

NPPES record last updated: December 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Michael A. Fishbaugh Jr. O.d. NPPES

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

DR. MICHAEL A. FISHBAUGH JR. O.D. (NPI 1225036197) is an individual optometrist in St. Henry, Ohio, licensed in Ohio (4643/T1418) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of Ohio State University - College Of Optometry (1995).

NPPES Registry Identity

NPI1225036197

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. MICHAEL A. FISHBAUGH JR.Credential: O.D.

Location Address570 KREMER HOYING RD., SUITE FSt. Henry, OH 45883-0040

Mailing Address570 E Kremer Hoying Rd Ste JSaint Henry, OH 45883-7600 · (419) 678-8800 · Fax (419) 678-4224

Phone(419) 678-8800

Fax(419) 678-4224

Sole ProprietorYes

Medical School CMSOhio State University - College Of OptometryGraduated 1995

Enumeration DateJuly 13, 2005

Last NPPES UpdateDecember 12, 2023

NPPES CertifiedDecember 12, 2023

✔ NPI 1225036197 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 OH · 4643/T1418

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.

570 KREMER HOYING RD., St. Henry, OH 45883

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Other Identifiers 8

Other34184720300OH · St Henry Bwc

Other410046531OH · Railroad Medicare

Other000000141871OH · Bc/bs

Other04072OH · Paramount Healthcare

OtherFI266725OH · Clarity

Medicaid0172343OH

Other34184720301OH · Doc Bwc

Other360656OH · Nva

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michael A. Fishbaugh Jr. O.d. 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 ID4688637689

PECOS Enrollment IDI20101215000238

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.

Areas of Expertise CMS Part B claims 20

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 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.

301 services160 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

247 services198 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.

202 services201 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.

157 services120 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.

147 services145 patients

Microfluid analysis of tears 83861

Microfluid analysis of tears involves collecting a small tear sample to examine its composition. This procedure can help detect health issues like dry eye disease, inflammation, or other eye conditions. It's a non-invasive, painless method for monitoring eye health.

144 services54 patients

Analysis of substance using immunoassay technique, multiple step method 83516

This procedure involves the use of an immunoassay, a highly sensitive technique, to detect and measure substances in your body. It involves multiple steps and is commonly used in diagnosing and monitoring various health conditions.

130 services49 patients

Extended exam involving color vision testing 92283

An extended exam involving color vision testing helps identify any difficulties in distinguishing colors, often due to genetic conditions or health problems. This non-invasive test involves identifying different colored numbers or patterns.

128 services126 patients

Evaluation of eye adaptation to light and dark with interpretation and report 92284

This procedure checks how your eyes adjust to different light conditions. In a dimly lit room, your eyes are first exposed to bright light. Then, the lights are turned off to see how quickly your eyes adapt to darkness. This helps identify any potential vision problems.

127 services113 patients

Photography of content of eyes 92285

Photography of the content of eyes, also known as ocular photography, captures detailed images of different parts of the eye. It helps identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. The process is non-invasive and painless.

122 services115 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

110 services98 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

101 services100 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

86 services78 patients

Measurement of retinal and optic nerve function 92273

This procedure checks the health of your eyes, specifically the retina and optic nerve. These parts help in visual interpretation. The test involves non-invasive techniques to measure your eye's response to light and assess its functioning.

56 services55 patients

Imaging of front third of eye 92132

Imaging of the front third of the eye, also known as anterior segment imaging, captures detailed images of the eye's front part. This includes the iris, cornea, and lens. It's a non-invasive procedure that helps diagnose and monitor eye conditions.

53 services52 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.

38 services38 patients

Exam of visual field with intermediate testing 92082

An exam of the visual field with intermediate testing is a procedure that checks your peripheral (side) vision. It helps to identify blind spots which could be a sign of eye diseases. This non-invasive test is painless and quick.

37 services37 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

18 services18 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

17 services17 patients

Ct scan of cornea 92025

A CT scan of the cornea is a non-invasive imaging test that uses X-rays to capture detailed pictures of your eye's cornea. It helps in diagnosing diseases or damage, planning for surgery, or evaluating the results of a treatment. It's a safe and painless procedure.

12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45883 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.10 – $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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

100

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Dilated Macular Examination

97%120 patients4/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

86%58 patients4/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

17%151 patients4/55-star benchmark: 98%

Documentation of Current Medications in the Medical Record

99%2,940 patients4/55-star benchmark: 100%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

98%1,440 patients4/55-star benchmark: 100%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 98% · 668 patients

Patients screened: 99% · 668 patients

95%95 patients4/55-star benchmark: 100%

Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care

98%141 patients

Provide Patients Electronic Access to Their Health Information

91%2,359 patients4/55-star benchmark: 100%

Tobacco Use and Help with Quitting Among Adolescents

96%245 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020

Other-Vision, Hearing, and Speech Services · category OC000N

1 supplier11 claims11 services$49.08 avg. paid by Medicare

Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens V2303

Other-Vision, Hearing, and Speech Services · category OC000N

1 supplier11 claims21 services$46.25 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Fishbaugh's NPI number?

The NPI number for Michael Fishbaugh is 1225036197. It was assigned to this individual provider in the NPPES registry on July 13, 2005.

Where is Michael Fishbaugh located?

Michael Fishbaugh practices at 570 Kremer Hoying Rd. Suite F, St. Henry, OH 45883. The listed phone number is (419) 678-8800.

What is Michael Fishbaugh's specialty?

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

Is Michael Fishbaugh enrolled in Medicare?

Yes. Michael Fishbaugh 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.

What insurance does Michael Fishbaugh accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana and 10 other insurers list Michael Fishbaugh 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 Fishbaugh was last updated on December 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.