Individual provider Active NPI

Susmitha Narisetty

  • Optometrist
  • Jackson, MI
National Provider Identifier
1356175657
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
00000000000 Issued in MI
Practice address
2575 Airport Rd
Jackson, MI 49202-1867
Phone
(517) 783-2883
NPI assigned
Aug 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 00000000000 MI Primary

Addresses

Primary practice location

2575 Airport Rd
Jackson, MI 49202-1867

Mailing address

2575 Airport Rd
Jackson, MI 49202-1867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NY2 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
I20250618003408 MI Practitioner - Optometry 8224549985 Reassigns benefits to 1 organization
I20260408000714 NY Practitioner - Optometry 8224549985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SVS Vision IncGroup PAC ID 9931257110, 41 clinicians

Practice addresses (Care Compare)

2575 Airport Rd
Jackson, MI 49202-1867
Phone (517) 783-2883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00000000000MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
SVS Vision Inc Optometrist CurrentSince Jul 1, 2025 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Jul 1, 2025 Accepting new patients

Locations

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

2575 Airport Rd
Jackson, MI 49202
Phone (517) 783-2883

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

4930 Marsh Rd
Okemos, MI 48864
Phone (517) 709-8010

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": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1356175657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 AIRPORT RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 AIRPORT RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021867",
            "telephone_number": "517-783-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARISETTY",
        "first_name": "SUSMITHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "00000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.