Individual provider Active NPI

Paul F Perse, OD

  • Optometrist
  • Sterling Heights, MI
National Provider Identifier
1215083308
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002486 Issued in MI
Practice address
37120 Dequindre
Sterling Heights, MI 48310
Phone
(586) 979-6260
Fax
(586) 979-1478
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002486 MI Primary

Addresses

Primary practice location

37120 Dequindre
Sterling Heights, MI 48310

Mailing address

140 Macomb
Mt Clemens, MI 48043
Phone (586) 468-7370

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
I20090714000740 MI Practitioner - Optometry 8527110030 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901002486MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Word Optical Group LLC Optometrist CurrentSince Jun 17, 2024 Accepting new patients

Locations

50505 Schoenherr Rd
Ste 110
Shelby Township, MI 48315
Phone (586) 803-3152

Organizations & group practices 1

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215083308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MACOMB",
            "city": "MT CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "586-468-7370",
            "fax_number": "586-464-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37120 DEQUINDRE",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48310",
            "telephone_number": "586-979-6260",
            "fax_number": "586-979-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSE",
        "first_name": "PAUL",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.