Organization Active NPI

SVS Vision Inc

  • Optometrist
  • Dearborn Heights, MI
National Provider Identifier
1265567069
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SVS VISION INC
Practice address
26671 Ford Rd.
Dearborn Heights, MI 48127
Phone
(734) 458-5181
Fax
(734) 458-8080
NPI assigned
Feb 22, 2007
Last updated
Nov 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Mr. Robert G Farrell Jr., OD
Title
Ceo/Owner
Phone
(586) 468-7370

Specialties & licenses 2

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

Addresses

Primary practice location

26671 Ford Rd.
Dearborn Heights, MI 48127

Mailing address

118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 468-7370

Other identifiers 1

IdentifierTypeStateIssuer
4500454MedicaidMI

Other names 1

  • SVS VISION 25 Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090427000507 MI Part B Supplier - Clinic/Group Practice 9931257110 Receives reassigned benefits from 109 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

5932 Middlebelt Rd
Garden City, MI 48135
Phone (734) 458-5181

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": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1265567069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CASS AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432204",
            "telephone_number": "586-468-7370",
            "fax_number": "586-468-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26671 FORD RD.",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "48127",
            "telephone_number": "734-458-5181",
            "fax_number": "734-458-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SVS VISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "586-468-7370",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4500454",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SVS VISION 25",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SVS VISION 25",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.