Laura Suzanne Lane, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003727 Issued in MI

Practice address

4325 Miller Rd
Flint, MI 48507

Phone

(810) 230-9292

NPI assigned

Feb 11, 2007

Last updated

Sep 7, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Laura Masters Koon Former name

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Optometry

Education

Ferris State College - College of Optometry, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optical Management Services LLCGroup PAC ID 3375765803, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optical Management Services, LLC

  dba Riverfront Optical Eyecare

  • Optometrist
  • Saginaw, MI
  • NPI 1720481484
  Medicare reassignment Care Compare group NPD
• Optical Management Services, LLC

  dba Riverfront Eyecare

  • Optometrist
  • Shelby Township, MI
  • NPI 1255870960
  NPD
• Optical Management Services, LLC

  dba Riverfront Optical Eyecare

  • Optometrist
  • Flint, MI
  • NPI 1538562988
  NPD
• Pearle Vision Inc

  • Optometrist
  • New Hudson, MI
  • NPI 1891840682
  NPD (past)
• Pearle Vision Inc

  dba Pearle Vision #C6672

  • Eyewear Supplier
  • Fairview Heights, IL
  • NPI 1982744033
  NPD (past)

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1346381373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 MILLER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071216",
            "telephone_number": "810-230-9292",
            "fax_number": "810-230-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 MILLER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48507",
            "telephone_number": "810-230-9292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 N Lapeer Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Orion",
            "state": "MI",
            "postal_code": "483621527",
            "country_code": "US",
            "telephone_number": "248-814-7011",
            "fax_number": "248-814-7014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "LAURA",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-11",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "KOON",
            "middle_name": "MASTERS",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nichole Leann Landers, PRC
• Landis Vision Center LLC
• Jared M Landry, RN
• Erica Lane
• Frederick Lane
• Shavon Lane, BSHS, CMHP, QMHP, QI
• Vincent Lang, BA
• Alexandria Nicole Lange
• Rebekah Kay Lange, PHYSICIAN ASSISTANT
• Shawn Yvette Langford

• Optometrist in Flint, MI
• Providers in Flint, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.