Individual provider Active NPI

Ali Khalil Chukr

  • Optometrist
  • Dearborn, MI
National Provider Identifier
1104673144
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005812 Issued in MI
Practice address
1922 Monroe St
Dearborn, MI 48124-2917
Phone
(616) 949-2600
NPI assigned
May 6, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005812 MI Primary

Addresses

Primary practice location

1922 Monroe St
Dearborn, MI 48124-2917

Mailing address

5262 Steadman St
Dearborn, MI 48126-3089
Phone (313) 442-2915

Other practice location 1

735 John R Rd
Troy, MI 48083-5856
Phone (248) 951-0000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240817000163 MI Practitioner - Optometry 8729526090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Sky Vision Eye Care PCGroup PAC ID 8820065618, 51 clinicians

Practice addresses (Care Compare)

1922 Monroe St
Dearborn, MI 48124-2917
Phone (313) 274-7540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005812MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Sky Vision Eye Care, PC CurrentSince Sep 11, 2024 Accepting new patients
Pcor, LLC Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Pcor LLC Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Blue Sky Vision Eye Care, P.C Optometrist CurrentSince Sep 11, 2024 Accepting new patients

Locations

19335 Allen Rd
Brownstown Twp, MI 48183
Phone (734) 479-5580

33100 S Gratiot Ave
Clinton Twp, MI 48035
Phone (586) 294-0120

1922 Monroe St
Dearborn, MI 48124
Phone (313) 274-7540

750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 588-6506

735 John R Rd
Troy, MI 48083
Phone (248) 544-3290

735 John R Rd
Ste 150
Troy, MI 48083
Phone (248) 588-9300

35184 Central City Pkwy
Westland, MI 48185
Phone (734) 427-5200

Interoperability endpoints

  • Direct secure messaging: achukr@optimeyes.emadirect.md
  • Direct secure messaging: achukr600271@direct.hfhs.org
  • Direct secure messaging: ali.chukr.p1@direct.grophthalmology.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1104673144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5262 STEADMAN ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263089",
            "telephone_number": "313-442-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242917",
            "telephone_number": "616-949-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "735 John R Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480835856",
            "country_code": "US",
            "telephone_number": "248-951-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUKR",
        "first_name": "ALI",
        "middle_name": "KHALIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-06",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.