Active NPI
Jardon Eye Prosthetics, Inc.
- Durable Medical Equipment & Medical Supplies
- Southfield, MI
National Provider Identifier
1255344305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- JARDON EYE PROSTHETICS, INC.
- Practice address
- 15920 W 12 Mile Rd
Southfield, MI 48076-3047 - Phone
- (248) 424-8560
- NPI assigned
- Aug 13, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Lee J Morris, OCULARIST
- Title
- President
- Phone
- (248) 424-8560
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | MI | Primary |
Addresses
Primary practice location
15920 W 12 Mile Rd
Southfield, MI 48076-3047
Mailing address
15920 W 12 Mile Rd
Southfield, MI 48076-3047
Phone (248) 424-8560
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000006595 | Other | MI | CAPE HEALTH PLAN |
| P500490 | Other | MI | CARE CHOICES |
| 500490 | Other | MI | MERCY HEALTH PLANS |
| 5131 | Other | MI | PRIORITY HEALTH |
| 49394 | Other | MI | OMNICARE |
| 82-09450 | Other | MI | PHP LANSING |
| 0F30983 | Other | MI | BLUECARE NETWORK |
| 80276A | Other | MI | HAP |
| 2829576 | Medicaid | MI | |
| 82-29048 | Other | MI | PHP-JACKSON |
| 8333001 | Other | MI | AETNA |
| OP630172 | Other | MI | M-CARE |
| 120109-0001 | Other | MI | WELLNESS PLAN |
| 1267 | Other | MI | NORTHWOODS |
| 9002104 | Other | MI | HEALTH PLUS |
| ANO369 | Other | MI | SELECT CARE |
| 29933 | Other | MI | COMMUNITY CHOICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930025457 | MI | DME Supplier - Medical Supply Company With Prosthetic Personnel | 7719004787 | Practice locations: Southfield, MI |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Jardon Eye Prosthetics, Inc. | Ocular Prostheses | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
15920 W 12 Mile Rd
Southfield, MI 48076
Phone (248) 424-8560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1255344305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15920 W 12 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480763047",
"telephone_number": "248-424-8560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15920 W 12 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480763047",
"telephone_number": "248-424-8560"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JARDON EYE PROSTHETICS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-13",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MORRIS",
"authorized_official_first_name": "LEE",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "248-424-8560",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "OCULARIST"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPE HEALTH PLAN",
"identifier": "000000006595",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE CHOICES",
"identifier": "P500490",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY HEALTH PLANS",
"identifier": "500490",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY HEALTH",
"identifier": "5131",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OMNICARE",
"identifier": "49394",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP LANSING",
"identifier": "82-09450",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE NETWORK",
"identifier": "0F30983",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HAP",
"identifier": "80276A",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2829576",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP-JACKSON",
"identifier": "82-29048",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "8333001",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "M-CARE",
"identifier": "OP630172",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLNESS PLAN",
"identifier": "120109-0001",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTHWOODS",
"identifier": "1267",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS",
"identifier": "9002104",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECT CARE",
"identifier": "ANO369",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY CHOICE",
"identifier": "29933",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.