Organization Active NPI

Eye Care Plus

  • Optometrist
  • Birch Run, MI
National Provider Identifier
1073025516
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE CARE PLUS
Practice address
8470 Main St
Birch Run, MI 48415-9461
Phone
(989) 624-2020
Fax
(989) 624-6257
NPI assigned
Oct 24, 2017
Last updated
Sep 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Authorized official

Name
Nicole Jaruzel
Title
Office Manager
Phone
(624) 624-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

8470 Main St
Birch Run, MI 48415-9461

Mailing address

8470 Main St
Birch Run, MI 48415-9461
Phone (989) 624-2020

Other identifiers 1

IdentifierTypeStateIssuer
4743837MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171211001575 MI Part B Supplier - Clinic/Group Practice 7214295740 Receives reassigned benefits from 5 practitioners
Practice locations: Birch Run, MI

National Provider Directory

National Provider Directory

Locations

8470 Main St
Birch Run, MI 48415
Phone (989) 624-2020

Practitioners & affiliated clinicians

Practitioners 5

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": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1073025516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8470 MAIN ST",
            "city": "BIRCH RUN",
            "state": "MI",
            "postal_code": "484159461",
            "telephone_number": "989-624-2020",
            "fax_number": "989-624-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8470 MAIN ST",
            "city": "BIRCH RUN",
            "state": "MI",
            "postal_code": "484159461",
            "telephone_number": "989-624-2020",
            "fax_number": "989-624-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE PLUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "JARUZEL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "624-624-2020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4743837",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birch Run, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.