Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Blaze Sammon, OD

Individual provider Optometrist · NPI 1093442121

Dr. Blaze Sammon, OD is an Optometry in Iron Mountain, Michigan. Qualified in 2022, 4 years ago. Practices with Shoptikal LLC, a 192-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
4
Licensed in
MI
In the registry since
2022
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

W8159 S US Highway 2/141 Ste 102
Iron Mountain, MI 49801-9423
Phone: (906) 779-9164
Fax: (906) 774-5547
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 4901005661 (MI)

Record details

NPI number1093442121
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedAugust 8, 2022
Last updated in NPPESOctober 16, 2025
Certification dateOctober 16, 2025
Mailing addressW1974 Beaver Pete Rd, Vulcan, MI 49892-8226

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Shoptikal Llc — 192 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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