Individual provider Active NPI

Deborah Ann Sheere-Gallatin, OD

  • Optometrist
  • Flint, MI
National Provider Identifier
1003992652
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003836 Issued in MI
Practice address
4499 Town Center Pkwy
Flint, MI 48532-3425
Phone
(810) 733-7111
Fax
(810) 733-7141
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003836 MI Primary

Addresses

Primary practice location

4499 Town Center Pkwy
Flint, MI 48532-3425

Mailing address

7192 Setters Pointe Blvd
Brighton, MI 48116-6703
Phone (810) 733-7111

Other identifiers 1

IdentifierTypeStateIssuer
3463703MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110215001029 MI Practitioner - Optometry 4284740689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Livingston Eyecare Associates, LLCGroup PAC ID 3476766767, 2 clinicians

Practice addresses (Care Compare)

10105 Veterans Memorial Dr
Whitmore Lake, MI 48189-0680
Phone (810) 231-5800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901003836MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Livingston Eyecare Associates, LLC CurrentSince Feb 21, 2020 Accepting new patients
Diskin Diskin & Keoleian Dba Michigan Eye Institute PastSince Jun 1, 2000 Accepting new patients
Diskin Diskin & Keoleian Dba Michigan Eye Institute PastSince Jun 1, 2000 Accepting new patients
Diskin Diskin & Keoleian Dba Michigan Eye Institute PastSince Jun 1, 2000 Accepting new patients
Diskin Diskin & Keoleian Dba Michigan Eye Institute PastSince Jun 1, 2000 Accepting new patients

Locations

10105 Veterans Memorial Dr
Ste 100
Whitmore Lake, MI 48189

10105 Veterans Memorial Dr
Whitmore Lake, MI 48189
Phone (810) 231-5800

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1003992652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7192 SETTERS POINTE BLVD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481166703",
            "telephone_number": "810-733-7111",
            "fax_number": "810-733-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 TOWN CENTER PKWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323425",
            "telephone_number": "810-733-7111",
            "fax_number": "810-733-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEERE-GALLATIN",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3463703",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.