Organization Active NPI

SVS Vision Inc

Doing business as SVS Vision Optical Centers

  • Optometrist
  • Wixom, MI
National Provider Identifier
1073908174
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SVS VISION INC
Doing business as
SVS Vision Optical Centers
Practice address
29660 S Wixom Rd
Wixom, MI 48393-3430
Phone
(248) 313-5500
Fax
(248) 313-5510
NPI assigned
Apr 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Authorized official

Name
Dr. Robert G Farrell Jr., OD
Title
Owner
Phone
(586) 468-7370

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X MI

Addresses

Primary practice location

29660 S Wixom Rd
Wixom, MI 48393-3430

Mailing address

118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 464-1479

Other identifiers 1

IdentifierTypeStateIssuer
4500481MedicaidMI

Other names 1

  • SVS Vision Optical Centers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090427000507 MI Part B Supplier - Clinic/Group Practice 9931257110 Receives reassigned benefits from 109 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

29660 S Wixom Rd
Wixom, MI 48393
Phone (248) 313-5500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1073908174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CASS AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432204",
            "telephone_number": "586-464-1479",
            "fax_number": "586-464-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29660 S WIXOM RD",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483933430",
            "telephone_number": "248-313-5500",
            "fax_number": "248-313-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SVS VISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-06",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-468-7370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4500481",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SVS Vision Optical Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SVS Vision Optical Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wixom, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.