Lake Lazer Eye Center PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

LAKE LAZER EYE CENTER PC

Practice address

35776 Harper Ave
Clinton TWP, MI 48035-3212

Phone

(586) 792-3891

NPI assigned

Feb 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Shabbir Khambati, M.D.NPI 1104938257

Title

President

Phone

(586) 792-3891

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Lake Lazer Eye Center

  • Preferred Provider Organization
  • Novi, MI
  • NPI 1376732388

  O20070314000217

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: skhambati@llec.eyefinity-direct.com

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Lake Lazer Eye Center

  • Preferred Provider Organization
  • Novi, MI
  • NPI 1376732388
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shabbir Khambati, MD

  • Ophthalmology Physician
  • Clinton TWP, MI
  • NPI 1104938257
  Medicare reassignment Care Compare group NPD Authorized official
• Andrew Marcell, OD

  • Optometrist
  • Clinton Township, MI
  • NPI 1073197745
  Medicare reassignment Care Compare group NPD
• Alisha Khambati, MD

  • Ophthalmology Physician
  • Detroit, MI
  • NPI 1699416560
  Medicare reassignment Care Compare group
• Krystyn Kudla, O.D.

  • Optometrist
  • Detroit, MI
  • NPI 1164805099
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1003951575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35776 HARPER AVE",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480353212",
            "telephone_number": "586-792-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35776 HARPER AVE",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480353212",
            "telephone_number": "586-792-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE LAZER EYE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "KHAMBATI",
        "authorized_official_first_name": "SHABBIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-792-3891",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0501160",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4606945",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irene Despo Kyprianides, LMSW
• Samantha La Tulip
• Lacey Trent LMSW LLC
• Colleen Lafleur
• Robert J Lage, PTA
• Lakepointe Senior Care and Rehab Center, LLC
• Lakeshore Medical Center, P.C.
• Donald William Lakin, OD
• Crystal Sue Lamb II, LMSW
• Stephanie Lamerato, LMSW

• Ophthalmology Physician in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.