DAVID CANNON OD
NPI 1487630133
Optometrist in Traverse City, MI
About David Cannon Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVID CANNON OD (NPI 1487630133) is an individual optometrist in Traverse City, Michigan, licensed in Michigan (DC00295) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and is a graduate of Ferris State College - College Of Optometry (1982).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Accepted 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
David Cannon 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.
Medicare Billing Reassignment
Medicare enrollment records show David Cannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Traverse City, MI 49684
- Reassigned Medicare billing, Michigan enrollment
- 8 clinicians in this Medicare group
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
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49684 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 David Cannon's NPI number?
The NPI number for David Cannon is 1487630133. It was assigned to this individual provider in the NPPES registry on December 15, 2005.
Where is David Cannon located?
David Cannon practices at 3200 S Airport Rd W #146, Traverse City, MI 49684. The listed phone number is (231) 941-5440.
What is David Cannon's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is David Cannon enrolled in Medicare?
Yes. David Cannon 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 David Cannon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), David Cannon reassigns Medicare benefits to Nichols Optical Inc (Traverse City, 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 David Cannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does David Cannon accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana and 12 other insurers list David Cannon 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 David Cannon was last updated on July 29, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# David Cannon, OD · NPI 1487630133
Optometrist provider in Traverse City, Michigan. Individual provider, active in the CMS NPPES registry since December 15, 2005.
## Identity
- **NPI:** 1487630133 (Entity type: Individual)
- **Enumerated:** December 15, 2005
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** DC00295 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 3200 S AIRPORT RD W, #146, Traverse City, MI 49684-8117
- **Phone:** (231) 941-5440 · **Fax:** (231) 941-0893
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Nichols Optical Inc (NPI 1679558712, Traverse City, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Ferris State College - College Of Optometry, class of 1982
## Record status
- **NPPES last updated:** July 29, 2011
- **Other identifiers:** Medicaid 3278492 (MI); Medicare UPIN U17597; Medicare ID-Type Unspecified 0B87610002
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Source: [NPI Profile](https://npiprofile.com/npi/1487630133) · Data from the CMS NPPES public registry.