Individual provider Active NPI

Richard James Neuenfeldt, O.D.

  • Optometrist
  • Grand Blanc, MI
National Provider Identifier
1104867209
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003643 Issued in MI
Practice address
12770 S Saginaw St
Grand Blanc, MI 48439-1831
Phone
(810) 695-3500
Fax
(810) 695-3502
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 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 4901003643 MI Primary

Addresses

Primary practice location

12770 S Saginaw St
Grand Blanc, MI 48439-1831

Mailing address

12770 S Saginaw St
Grand Blanc, MI 48439-1831
Phone (810) 695-3500

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
I20121113000341 MI Practitioner - Optometry 7416108840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12770 S Saginaw St
Grand Blanc, MI 48439-1831
Phone (810) 695-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901003643MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard J Neuenfeldt Odpc Optometrist CurrentSince Dec 13, 2012 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

12770 S Saginaw St
Grand Blanc, MI 48439
Phone (810) 695-3500

12830 S Saginaw St
Ste C
Grand Blanc, MI 48439
Phone (810) 695-3500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1104867209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12770 S SAGINAW ST",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391831",
            "telephone_number": "810-695-3500",
            "fax_number": "810-695-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12770 S SAGINAW ST",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391831",
            "telephone_number": "810-695-3500",
            "fax_number": "810-695-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUENFELDT",
        "first_name": "RICHARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.