Individual provider Active NPI

Lisa Barry, O.D.

  • Optometrist
  • Shelby Township, MI
National Provider Identifier
1174670509
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003593 Issued in MI
Practice address
13301 Hall Rd
Shelby Township, MI 48315-5835
Phone
(810) 726-0290
NPI assigned
Jan 5, 2007
Last updated
Oct 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003593 MI Primary

Addresses

Primary practice location

13301 Hall Rd
Shelby Township, MI 48315-5835

Mailing address

1936 Broadstone Rd
Grosse Pointe Woods, MI 48236-1953
Phone (313) 515-3236

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
I20040306000235 MI Practitioner - Optometry 4183512668 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black and White Look Optical CorporationGroup PAC ID 7911920673, 2 clinicians

Practice addresses (Care Compare)

15675 W 10 Mile Rd
Southfield, MI 48075-2188
Phone (248) 557-6444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Vision Consultants, LLC Optometrist CurrentSince Jun 19, 2020 Accepting new patients
Eye Care for Detroit Optometrist CurrentSince Jan 13, 2025 Accepting new patients
Eye Care for Detroit CurrentSince Mar 30, 2025 Accepting new patients
Black and White Look Optical Corporation Optometrist CurrentSince Jul 7, 2018 Accepting new patients
Susan Mithoff Quade OD PC Optometrist PastSince Apr 1, 2004 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

2211 S Telegraph Rd
Unit 7061
Bloomfld Hls, MI 48302

12871 E Jefferson Ave
Detroit, MI 48215
Phone (313) 331-8484

7800 W Outer Dr
Ste 150
Detroit, MI 48235
Phone (313) 255-1507

18023 E 8 Mile Rd
Eastpointe, MI 48021
Phone (313) 614-5117

29273 Dequindre Rd
Madison Heights, MI 48071
Phone (248) 548-9355

27118 Gratiot Ave
Roseville, MI 48066
Phone (586) 447-1436

15675 W 10 Mile Rd
Southfield, MI 48075
Phone (248) 557-6444

29201 Telegraph Rd
Ste 602
Southfield, MI 48034
Phone (248) 357-5390

Organizations & group practices 6

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1174670509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 BROADSTONE RD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361953",
            "telephone_number": "313-515-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13301 HALL RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155835",
            "telephone_number": "810-726-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRY",
        "first_name": "LISA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.