MRS. MICHELLE MARIE MARTIN (O.D.) – Optometrist, NPI 1386652907

MRS. MICHELLE MARIE MARTIN (O.D.) is a healthcare provider. based in Maple grove, Minnesota. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 3053 (MN). The NPI Number for MRS. MICHELLE MARIE MARTIN (O.D.) is 1386652907

Main info

Female
20 Years Of Experience
Name
MRS. MICHELLE MARIE MARTIN (O.D.)
NPI
1386652907
Phone
(763) 553-1811
Address
12750 BASS LAKE RD
Enumeration Date
3 August 2006
Last Update Date
12 September 2008

Doctor Profile

Medical School Name
INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Secondary Phone
7635531811
Graduation Year
2006 (20 years ago)
PAC ID
9830289040
Group Practice PAC ID
5193964542
Professional Enrollment ID
I20071212000113
Address ID
MN553696307MA12750RDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

879 OPTOMETRY in MN

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Provider Addresses for MRS. MICHELLE MARIE MARTIN (O.D.)

  • Bass Lake Road, Maple Grove, Hennepin County, Minnesota, 55442, United States

    MAPLE GROVE, MN 553696307

    Phone: (763) 553-1811

    Fax: (763) 553-0131

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $284.

Total Amount is formed as General ($284) + Research ($0) + Ownership ($0) = $284.

Last reported payment date: 2024-11-26 • Largest payer in this snapshot: Alcon Vision LLC ($158).

Total Amount

$284

General + Research + Ownership

Payments

16

Total payment records

General Amount

$284

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-26

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-12-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20071212000113IOptometryMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system6161$0
View full utilization report →

Insurance plans in this area (ZIP 55369)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5193964542View full group profile
NameSpecialtyState
O P T O M E T R YMN

Reviews

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Frequently asked questions

Can I use this page to confirm MRS. MICHELLE MARIE MARTIN (O.D.)'s NPI?
Yes. MRS. MICHELLE MARIE MARTIN (O.D.) is listed with NPI 1386652907 in the public NPI dataset.
Does the file indicate MRS. MICHELLE MARIE MARTIN (O.D.) is practicing under active NPI?
Directory data currently reports MRS. MICHELLE MARIE MARTIN (O.D.) as active.
What taxonomy line describes MRS. MICHELLE MARIE MARTIN (O.D.)?
For research purposes, treat MRS. MICHELLE MARIE MARTIN (O.D.) as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
Does MRS. MICHELLE MARIE MARTIN (O.D.) list a practice location?
Patients near Maple Grove, Minnesota may find MRS. MICHELLE MARIE MARTIN (O.D.) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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