Specialized Eye Care and Eye Wear Services, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004572 Issued in MI

Legal business name

SPECIALIZED EYE CARE AND EYE WEAR SERVICES, PLLC

Practice address

1325 W South Airport Rd
Traverse City, MI 49686-4760

Phone

(231) 947-6767

NPI assigned

Jun 24, 2016

Last updated

Jul 12, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Scott J Soave, ODNPI 1629302468

Title

Optometrist

Phone

(480) 297-8336

Specialties & licenses 1

Addresses

Other names 1

• dunscombe optical Other name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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.

• Scott James Soave, O.D

  • Optometrist
  • Traverse City, MI
  • NPI 1629302468
  Medicare reassignment Care Compare group NPD Authorized official
• Johanna Mauk, O.D.

  • Optometrist
  • Gaylord, MI
  • NPI 1720439102
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1225489909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7269 SHORE RD NE",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496468770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 W SOUTH AIRPORT RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864760",
            "telephone_number": "231-947-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED EYE CARE AND EYE WEAR SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-24",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "SOAVE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "480-297-8336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dunscombe optical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Todd Christopher Space, MD
• Kristin M Sparks, PHARMD
• Erika L Spaulding
• Mareena R Spaulding
• Mason Delores Spear
• Specialized Personal Recovery Services LLC.
• Spectrum Health Hospitals
• Spectrum Health Hospitals
• Spectrum Health Primary Care Partners (Corewell Health Medical Group West)
• Spectrum Health Primary Care Partners (Corewell Health Medical Group West)

• Optometrist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.