NPIMap

Organization Active NPI

Pcor LLC

Doing business as Henry Ford Optimeyes

  • Optometrist
  • Southfield, MI
National Provider Identifier
1174799530
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PCOR LLC
Doing business as
Henry Ford Optimeyes
Practice address
29350 Southfield Rd
Southfield, MI 48076-2011
Phone
(248) 647-9790
Fax
(248) 901-1831
NPI assigned
May 6, 2008
Last updated
Sep 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Authorized official

Name
Mrs. Gail Elias
Title
Director of Finance
Phone
(248) 577-3624

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X MI
Optometrist 152W00000X MI Primary

Addresses

Primary practice location

29350 Southfield Rd
Southfield, MI 48076-2011

Mailing address

735 John R Rd Ste 150
Troy, MI 48083-5859
Phone (248) 588-9300

Other names 1

  • Henry Ford Optimeyes Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120215000106 MI DME Supplier - Physician - OptometristDME Supplier - Optician 9931194149 1 other NPI on this enrollment
Practice locations: Southfield, MI

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pcor - LLC26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

29350 Southfield Rd
Southfield, MI 48076
Phone (248) 569-9017

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568160000000",
    "number": "1174799530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 JOHN R RD STE 150",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835859",
            "telephone_number": "248-588-9300",
            "fax_number": "248-588-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29350 SOUTHFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762011",
            "telephone_number": "248-647-9790",
            "fax_number": "248-901-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2019-09-11",
        "status": "A",
        "authorized_official_last_name": "ELIAS",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "248-577-3624",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Optimeyes",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henry Ford Optimeyes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.