Individual provider Active NPI

Fatima Elchawich, OD

  • Optometrist
  • Brighton, MI
National Provider Identifier
1073260261
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005637 Issued in MI
Practice address
205 W Grand River Ave Ste 100
Brighton, MI 48116-1659
Phone
(810) 220-4499
NPI assigned
Mar 7, 2022
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005637 MI Primary

Addresses

Primary practice location

205 W Grand River Ave Ste 100
Brighton, MI 48116-1659

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

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
I20220621001571 MI Practitioner - Optometry 8325427438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2022
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

205 W Grand River Ave
Suite 100
Brighton, MI 48116-1659
Phone (810) 220-4499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince Jul 11, 2022 Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince Jul 11, 2022 Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist Current Accepting new patients

Locations

205 W Grand River Ave
Ste 100
Brighton, MI 48116
Phone (810) 220-4499

1675 N Canton Center Rd
Canton, MI 48187
Phone (734) 844-0400

800 S Brown St
Jackson, MI 49203
Phone (517) 787-8890

29474 7 Mile Rd
Livonia, MI 48152
Phone (248) 615-2815

44429 Ann Arbor Rd W
Plymouth, MI 48170
Phone (734) 416-0348

48873 Hayes Rd
Shelby Township, MI 48315
Phone (586) 247-2121

10798 Belleville Rd
Van Buren Township, MI 48111
Phone (734) 697-6671

22750 Allen Rd
Woodhaven, MI 48183
Phone (734) 676-4300

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1073260261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W GRAND RIVER AVE STE 100",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161659",
            "telephone_number": "810-220-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELCHAWICH",
        "first_name": "FATIMA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.