Individual provider Active NPI

Alpa M. Desai, O.D.

  • Optometrist
  • Northville, MI
National Provider Identifier
1013267830
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004737 Issued in MI
Practice address
17783 Haggerty Rd
Northville, MI 48168-9802
Phone
(248) 675-1875
Fax
(248) 449-4782
NPI assigned
Sep 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004737 MI Primary

Addresses

Primary practice location

17783 Haggerty Rd
Northville, MI 48168-9802

Mailing address

1958 E Franklin Dr
Canton, MI 48187-2914
Phone (734) 255-0783

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
I20170912000131 MI Practitioner - Optometry 2466725593 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901004737MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Black and White Look Optical Corporation Optometrist CurrentSince Dec 30, 2017 Accepting new patients
Hearing Associates of Farmington Hills, PLLC Past Accepting new patients

Locations

15675 W 10 Mile Rd
Southfield, MI 48075
Phone (248) 557-6444

Organizations & group practices 2

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": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1013267830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1958 E FRANKLIN DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872914",
            "telephone_number": "734-255-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17783 HAGGERTY RD",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481689802",
            "telephone_number": "248-675-1875",
            "fax_number": "248-449-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "ALPA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

Verify at the official NPI Registry.