Paul M Damlo, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901005565 Issued in MI

Practice address

20525 Mack Ave
Grosse Pointe Woods, MI 48236-1655

Phone

(313) 881-6622

Fax

(313) 881-9380

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eye Care for Detroit

  • Ophthalmology Physician
  • Detroit, MI
  • NPI 1396551701

  Optometrist

  Medicare reassignment NPD
• Pointe Vision Care PC

  • Optometrist
  • Grosse Pointe Woods, MI
  • NPI 1801830104
  NPD
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1083645626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20525 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361655",
            "telephone_number": "313-881-6622",
            "fax_number": "313-881-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20525 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361655",
            "telephone_number": "313-881-6622",
            "fax_number": "313-881-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMLO",
        "first_name": "PAUL",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2476",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329316500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin John Czerniawski, DDS MS
• Mehdi Fouad Dabaja, OD
• Donya Dabiri
• Alyssa Dall, AT, ATC
• Olivia Dallaire
• Aniya Jenay Daniel
• David C. Secord, D.D.S., P.C.
• David M. Urbanski, M.D., PLC
• Wayte Davill, MD
• Anthony Cortez Davis

• Optometrist in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.