Organization Active NPI

Schaff Vision Care, LLC

  • Optometrist
  • Jackson, MI
National Provider Identifier
1043305899
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002927 Issued in MI
Legal business name
SCHAFF VISION CARE, LLC
Practice address
2700 Wildwood Ave
Jackson, MI 49202-3933
Phone
(517) 789-8119
Fax
(517) 789-6276
NPI assigned
Oct 4, 2006
Last updated
Oct 31, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Authorized official

Name
Carolyn Schaff
Title
Office Manager
Phone
(517) 789-8119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002927 MI Primary

Addresses

Primary practice location

2700 Wildwood Ave
Jackson, MI 49202-3933

Mailing address

2700 Wildwood Ave
Jackson, MI 49202-3933
Phone (517) 789-8119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040920000023 MI Part B Supplier - Clinic/Group Practice 3072581966 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jackson, MI
O20100930070568 MI DME Supplier - Physician - Optometrist 3072581966 Practice locations: Jackson, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Schaff Vision Care LLC2700 Wildwood Ave, Jackson, MI 49202-3933(517) 789-8119 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jun 24, 2004

National Provider Directory

National Provider Directory

Locations

114 W Erie St
Albion, MI 49224
Phone (517) 629-3981

2700 Wildwood Ave
Jackson, MI 49202
Phone (517) 230-5547

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1043305899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 WILDWOOD AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023933",
            "telephone_number": "517-789-8119",
            "fax_number": "517-789-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 WILDWOOD AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023933",
            "telephone_number": "517-789-8119",
            "fax_number": "517-789-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHAFF VISION CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "SCHAFF",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "517-789-8119"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.