Active NPI
David Matthew Tykocki, O.D.
- Optometrist
- Flint, MI
National Provider Identifier
1093703589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901002223
- Practice address
- 523 M L King Ave
Flint, MI 48502-2002 - Phone
- (810) 238-0925
- Fax
- (810) 238-6641
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901002223 | MI | Primary |
Addresses
Primary practice location
523 M L King Ave
Flint, MI 48502-2002
Mailing address
523 M L King Ave
Flint, MI 48502-2002
Phone (810) 238-0925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901002223 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General Optical Company | Optometrist | Past | Accepting new patients |
| Attractive Eyewear Inc | Past | Accepting new patients | |
| Eye Clinic of Livonia, P.C. | Optometrist | Past | Accepting new patients |
| Luxottica of America Inc | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Optician
- Livonia, MI
- NPI 1508955709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1093703589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 M L KING AVE",
"city": "FLINT",
"state": "MI",
"postal_code": "485022002",
"telephone_number": "810-238-0925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 M L KING AVE",
"city": "FLINT",
"state": "MI",
"postal_code": "485022002",
"telephone_number": "810-238-0925",
"fax_number": "810-238-6641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYKOCKI",
"first_name": "DAVID",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901002223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.