SOUTH MICHIGAN OPHTHALMOLOGY P C
NPI 1629224514
Clinic/Center in Marshall, MI
About South Michigan Ophthalmology P C NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH MICHIGAN OPHTHALMOLOGY P C (NPI 1629224514) is a healthcare organization registered as a clinic/center in Marshall, Michigan and active in the NPI registry since August 2008. The organization lists Darren Paul Hathaway, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Michigan Ophthalmology P C is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to South Michigan Ophthalmology P C, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 South Michigan Ophthalmology P C's NPI number?
The NPI number for South Michigan Ophthalmology P C is 1629224514. It was assigned to this organization in the NPPES registry on August 12, 2008.
Where is South Michigan Ophthalmology P C located?
South Michigan Ophthalmology P C is located at 830 W Michigan Ave, Marshall, MI 49068. The listed phone number is (269) 781-9822.
What is South Michigan Ophthalmology P C's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is South Michigan Ophthalmology P C enrolled in Medicare?
Yes. South Michigan Ophthalmology P C is registered in the Medicare PECOS enrollment system.
When is South Michigan Ophthalmology P C's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through South Michigan Ophthalmology P C?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to South Michigan Ophthalmology P C, in Ophthalmology and Optometry. A 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 the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does South Michigan Ophthalmology P C accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Care Network of Michigan and 3 other insurers list South Michigan Ophthalmology P C 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 South Michigan Ophthalmology P C was last updated on August 10, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# South Michigan Ophthalmology P C · NPI 1629224514
Clinic/Center organization in Marshall, Michigan. Organization record, active in the CMS NPPES registry since August 12, 2008.
## Identity
- **NPI:** 1629224514 (Entity type: Organization)
- **Enumerated:** August 12, 2008
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Organization subpart:** No
- **Authorized official:** Darren Hathaway, PRESIDENT
## Practice location
- **Address:** 830 W MICHIGAN AVE, Marshall, MI 49068-1446
- **Phone:** (269) 781-9822 · **Fax:** (269) 781-9835
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Ophthalmology (1), Optometry (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 10, 2010
- **Other identifiers:** Medicare UPIN G83248 (MI); Medicare PIN 0N52860 (MI); Medicaid 4421664 (MI); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1629224514) · Data from the CMS NPPES public registry.