NPIMap

Organization Active NPI

Blue Sky Vision Eye Care, PC

  • Ophthalmology Physician
  • Dearborn, MI
National Provider Identifier
1316675598
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
BLUE SKY VISION EYE CARE, PC
Practice address
1922 Monroe St
Dearborn, MI 48124-2917
Phone
(313) 274-7540
NPI assigned
Aug 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Authorized official

Name
Joseph Pravoot GiraNPI 1861481152
Title
Owner
Phone
(314) 909-0633

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1922 Monroe St
Dearborn, MI 48124-2917

Mailing address

1922 Monroe St
Dearborn, MI 48124-2917
Phone (313) 274-7540

Other names 1

  • Tukel Eye Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240821000508 MI DME Supplier - Physician - Ophthalmology 8820065618 Practice locations: Dearborn, MI

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Grand Rapids Ophth PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

511 Wilson Ave NW
Grand Rapids, MI 49534
Phone (616) 301-8663

426 Michigan St NE
Ste 102
Grand Rapids, MI 49503
Phone (616) 267-7888

4475 Wilson Ave SW
Grandville, MI 49418
Phone (616) 249-0100

705 S Greenville West Dr
Ste 201
Greenville, MI 48838
Phone (616) 754-5667

Practitioners & affiliated clinicians

Practitioners 76

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 76

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1316675598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242917",
            "telephone_number": "313-274-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242917",
            "telephone_number": "313-274-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY VISION EYE CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "GIRA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "PRAVOOT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-909-0633"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tukel Eye Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tukel Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.