Individual provider Active NPI

Ann Lacroix Fredal, O.D. PLLC

  • Optometrist
  • Mount Clemens, MI
National Provider Identifier
1295815926
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002973 Issued in MI
Practice address
136 Cass Ave
Mount Clemens, MI 48043-2230
Phone
(586) 468-4211
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 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 002973 MI Primary

Addresses

Primary practice location

136 Cass Ave
Mount Clemens, MI 48043-2230

Mailing address

136 Cass Ave
Mount Clemens, MI 48043-2230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 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
I20101214001206 MI Practitioner - Optometry 2163549148 Reassigns benefits to 1 organization
O20100930018225 MI DME Supplier - Physician - Optometrist 4981715281 Practice locations: Mount Clemens, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ann Lacroix Fredal OD PLLCGroup PAC ID 4981715281, 3 clinicians

Practice addresses (Care Compare)

136 Cass Ave
Mount Clemens, MI 48043-2230
Phone (586) 468-4211

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002973MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ann Lacroix Fredal O.D. PLLC CurrentSince Feb 12, 2001 Accepting new patients

Locations

136 Cass Ave
Mount Clemens, MI 48043
Phone (586) 468-4211

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1295815926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 CASS AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 CASS AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432230",
            "telephone_number": "586-468-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDAL",
        "first_name": "ANN",
        "middle_name": "LACROIX",
        "credential": "O.D. PLLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "002973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.