Individual provider Active NPI

Nina Pakzad, OD

  • Optometrist
  • Troy, MI
National Provider Identifier
1336915560
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005743 Issued in MI
Practice address
2910 W Maple Rd
Troy, MI 48084-7031
Phone
(248) 435-2189
Fax
(248) 435-2302
NPI assigned
Nov 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005743 MI Primary

Addresses

Primary practice location

2910 W Maple Rd
Troy, MI 48084-7031

Mailing address

118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 464-1479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 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
I20231205002200 MI Practitioner - Optometry 5597114389 Reassigns benefits to 1 organization
I20250822003321 FL Practitioner - Optometry 5597114389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Nova Southeastern College of Osteo Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Florida Professional PLLCGroup PAC ID 3870960032, 70 clinicians

Practice addresses (Care Compare)

3615 W Woolbright Rd
Elite Vision Care Boynton Beach
Boynton Beach, FL 33436-7244
Phone (561) 734-1887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Florida Professional PLLC Optometrist CurrentSince Jun 25, 2025 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Nov 30, 2023 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Nov 30, 2023 Accepting new patients
The Elite Vision Care, Inc Optometrist PastSince Jan 1, 2021 Accepting new patients

Locations

3615 W Woolbright Rd
Boynton Beach, FL 33436
Phone (561) 734-1884

4788 Hodges Blvd
Ste 205
Jacksonville, FL 32224
Phone (904) 992-9991

5330 SW College Rd
#O
Ocala, FL 34474
Phone (352) 512-0560

4252 Northlake Blvd
Palm Beach Gardens, FL 33410
Phone (561) 355-8788

111 E 4th St
Ste 440
Alton, IL 62002

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

2910 W Maple Rd
Troy, MI 48084
Phone (248) 435-2189

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1336915560",
    "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": "586-464-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 W MAPLE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480847031",
            "telephone_number": "248-435-2189",
            "fax_number": "248-435-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKZAD",
        "first_name": "NINA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.