NPIMap

Organization Active NPI

Comprehensive Vision Center P.C.

  • Ophthalmology Physician
  • South Lyon, MI
National Provider Identifier
1104188515
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301080629 Issued in MI
Legal business name
COMPREHENSIVE VISION CENTER P.C.
Practice address
321 Pettibone St
Suite 103
South Lyon, MI 48178-6000
Phone
(248) 782-8120
Fax
(248) 278-6096
NPI assigned
Jun 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Authorized official

Name
Dr. Christopher Papp, M.DNPI 1669493342
Title
President
Phone
(248) 826-4929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 4301080629 MI Primary

Addresses

Primary practice location

321 Pettibone St
Suite 103
South Lyon, MI 48178-6000

Mailing address

PO Box 3820
Ann Arbor, MI 48106-3820
Phone (248) 826-4929

Other practice location 1

32410 Five Mile Rd Ste 102
Livonia, MI 48154-3080
Phone (734) 522-9630

Other identifiers 1

IdentifierTypeStateIssuer
1669493342MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120914000258 MI Part B Supplier - Clinic/Group Practice 4981852076 Receives reassigned benefits from 2 practitioners
Practice locations: Livonia, MI; South Lyon, MI; Walled Lake, MI

National Provider Directory

National Provider Directory

Locations

321 Pettibone St
#103
South Lyon, MI 48178
Phone (248) 782-8120

321 Pettibone St
Ste 103
South Lyon, MI 48178
Phone (248) 782-8120

321 Pettibone St
South Lyon, MI 48178

Practitioners & affiliated clinicians

Practitioners 6

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": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1104188515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3820",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481063820",
            "telephone_number": "248-826-4929",
            "fax_number": "248-278-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 PETTIBONE ST",
            "address_2": "SUITE 103",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481786000",
            "telephone_number": "248-782-8120",
            "fax_number": "248-278-6096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32410 Five Mile Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481543080",
            "country_code": "US",
            "telephone_number": "734-522-9630",
            "fax_number": "734-522-9636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMPREHENSIVE VISION CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-12",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "PAPP",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-826-4929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301080629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669493342",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lyon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.