Individual provider Active NPI

Amna Vahidy

  • Optometrist
  • Grosse Pointe Woods, MI
National Provider Identifier
1285457002
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005846 Issued in MI
Practice address
19173 Mack Ave
Grosse Pointe Woods, MI 48236-2803
Phone
(313) 882-7883
NPI assigned
Nov 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005846 MI Primary

Addresses

Primary practice location

19173 Mack Ave
Grosse Pointe Woods, MI 48236-2803

Mailing address

19173 Mack Ave
Grosse Pointe Woods, MI 48236-2803
Phone (313) 882-7883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250224003532 MI Practitioner - Optometry 6103346911 Reassigns benefits to 1 organization
I20260406001636 IL Practitioner - Optometry 6103346911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

868 N Wells St
Apt 712
Chicago, IL 60610-3675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005846MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
SVS Vision Inc Optometrist CurrentSince Dec 19, 2024 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Dec 19, 2024 Accepting new patients

Locations

455 E Grand River Ave
Brighton, MI 48116
Phone (810) 227-2376

19173 Mack Ave
Grosse Pointe Woods, MI 48236
Phone (313) 882-7883

118 Cass Ave
Mount Clemens, MI 48043
Phone (586) 464-1479

Organizations & group practices 3

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": "1730419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1285457002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19173 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362803",
            "telephone_number": "313-882-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19173 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362803",
            "telephone_number": "313-882-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHIDY",
        "first_name": "AMNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-01",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.