Individual provider Active NPI

Jillian L Boyd, OD

  • Optometrist
  • Rochester Hills, MI
National Provider Identifier
1134612450
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005123 Issued in MI
Practice address
375 Barclay Cir
Rochester Hills, MI 48307
Phone
(248) 852-3636
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005123 MI Primary

Addresses

Primary practice location

375 Barclay Cir
Rochester Hills, MI 48307

Mailing address

375 Barclay Cir
Rochester Hills, MI 48307-4511
Phone (248) 852-3636

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
I20181019002047 MI Practitioner - Optometry 6204189376 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Eye Center PC 4 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (586) 416-1544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005123MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Optical Clinic, Inc. Optometrist CurrentSince Oct 10, 2018 Accepting new patients
Riverside Eye Center PC Optometrist CurrentSince Jun 1, 2024 Accepting new patients
Millman-Derr Center for Eye Care, P.C. CurrentSince Feb 19, 2019 Accepting new patients
Millman-Derr Center for Eye Care, P.C. CurrentSince Feb 19, 2019 Accepting new patients

Locations

4050 River Rd
Ste 1
East China, MI 48054
Phone (810) 329-9045

4656 24th Ave
Fort Gratiot, MI 48059
Phone (810) 385-3600

32925 Groesbeck Hwy
Fraser, MI 48026
Phone (586) 293-8888

17900 23 Mile Rd
Ste 100
Macomb, MI 48044
Phone (248) 852-3636

211 N State St
Oscoda, MI 48750
Phone (517) 739-2020

375 Barclay Cir
Rochester Hills, MI 48307
Phone (248) 491-8894

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.

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1134612450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 BARCLAY CIR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483074511",
            "telephone_number": "248-852-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 BARCLAY CIR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "48307",
            "telephone_number": "248-852-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "JILLIAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.