Main Street Optometry, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003882 Issued in MI

Legal business name

MAIN STREET OPTOMETRY, INC.

Practice address

8089 Main St
Suite 1
Dexter, MI 48130-1079

Phone

(734) 424-9230

Fax

(734) 424-2576

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Renee Lynn Laliberte, O.D.NPI 1558346155

Title

Owner

Phone

(734) 424-9230

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Main Street Optometry, Inc.

  • Optometrist
  • Pinckney, MI
  • NPI 1801954565

  O20040628000264

  Same enrollment

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

CLIA laboratory certificates

Locations

Practitioners 3

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

• Renee Lynn Laliberte, O.D.

  • Optometrist
  • Dexter, MI
  • NPI 1558346155
  NPD Authorized official
• Robert Ray Baltierra

  • Optometrist
  • Dexter, MI
  • NPI 1013442094
  NPD (past)
• Amanda Marie Himmel, O.D.

  • Optometrist
  • Pinckney, MI
  • NPI 1174143507
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393286400000",
    "number": "1083772008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8089 MAIN ST",
            "address_2": "SUITE 1",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301079",
            "telephone_number": "734-424-9230",
            "fax_number": "734-424-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8089 MAIN ST",
            "address_2": "SUITE 1",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301079",
            "telephone_number": "734-424-9230",
            "fax_number": "734-424-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2014-02-25",
        "status": "A",
        "authorized_official_last_name": "LALIBERTE",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-424-9230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifetime Dental Care of Michigan, P.C.
• Anna Lockridge
• Loranger Family Chiropractic Health Center, P.C.
• Richelle Anne Madden
• Emily Madrigal, LPC
• Maira M Rodriguez DMD PC
• Ashleigh Eileen Mallia
• Doni Rebecca Mallia, D.D.S.
• Susan E Maples, NP
• Roy Edgar Margenau III, D.D.S.

• Optometrist in Dexter, MI
• Providers in Dexter, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.