Individual provider Active NPI

Miranda Geisinger, OD

  • Optometrist
  • Novi, MI
National Provider Identifier
1366179798
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
49010056665 Issued in MI
Practice address
41555 W Twelve Mile Rd
Novi, MI 48377-3103
Phone
(248) 675-0800
Fax
(248) 675-0545
NPI assigned
Aug 5, 2022
Last updated
Jun 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 49010056665 MI Primary
Optometrist 152W00000X 18004356A IN

Addresses

Primary practice location

41555 W Twelve Mile Rd
Novi, MI 48377-3103

Mailing address

41555 W Twelve Mile Rd
Novi, MI 48377-3103
Phone (248) 675-0800

Other practice location 1

35184 Central City Pkwy
Westland, MI 48185-6215
Phone (734) 427-5200

Other practice location 2

744 E 3rd St
Bloomington, IN 47405-3603
Phone (812) 855-8436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in 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
I20220809001227 IN Practitioner - Optometry 1153703087 Reassigns benefits to 1 organization
I20230705001805 MI Practitioner - Optometry 1153703087 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18004356AINMDOptometrist
49010056665MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Optometrist CurrentSince Aug 5, 2022 Accepting new patients
University of Detroit Mercy Optometrist CurrentSince Jun 23, 2025 Accepting new patients
Indiana University Optometrist Current Accepting new patients
Indiana University CurrentSince Aug 5, 2022 Accepting new patients
Pcor LLC Optometrist CurrentSince Jun 26, 2023 Accepting new patients
Pcor, LLC Optometrist CurrentSince Jun 26, 2023 Accepting new patients
P-Cor LLC Optometrist PastSince Feb 24, 2022 Accepting new patients
P-Cor, LLC Optometrist PastSince Dec 12, 2021 Accepting new patients
University of Detroit Mercy PastSince Jun 23, 2025 Accepting new patients
P-Cor, LLC Optometrist Past Accepting new patients
P-Cor, LLC Optometrist Past Accepting new patients

Locations

744 E 3rd St
Bloomington, IN 47405
Phone (812) 855-8436

800 E Atwater Ave
Rm 263
Bloomington, IN 47405

1961 S Telegraph Rd
Ste 101
Bloomfield Township, MI 48302
Phone (248) 972-2555

27903 23 Mile Rd
Chesterfield, MI 48051
Phone (586) 598-3935

33100 S Gratiot Ave
Clinton Twp, MI 48035
Phone (586) 294-0120

3271 Union Lake Rd
Commerce Twp, MI 48382
Phone (248) 360-0121

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

22500 Haggerty Rd
Farmington Hills, MI 48335
Phone (248) 477-9300

4281 24th Ave
Fort Gratiot, MI 48059
Phone (810) 385-4000

15401 E Jefferson Ave
Grosse Pointe Park, MI 48230
Phone (313) 824-2401

1376 S Lapeer Rd
#A
Lake Orion, MI 48360
Phone (248) 693-3380

516 Highland Ave
Milford, MI 48381
Phone (248) 577-3616

504 N Telegraph Rd
Monroe, MI 48162
Phone (734) 243-2020

41555 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 675-0285

40895 Ann Arbor Rd E
Plymouth, MI 48170
Phone (734) 233-6300

110 E 2nd St
Royal Oak, MI 48067
Phone (248) 546-2110

2025 25 Mile Rd
Shelby Township, MI 48316
Phone (248) 651-3937

29350 Southfield Rd
Southfield, MI 48076
Phone (248) 569-9017

44987 Schoenherr Rd
Sterling Hts, MI 48313
Phone (586) 247-5910

22395 Eureka Rd
Taylor, MI 48180
Phone (248) 661-5100

735 John R Rd
Troy, MI 48083
Phone (248) 544-3290

735 John R Rd
Ste 150
Troy, MI 48083
Phone (248) 588-9300

35184 Central City Pkwy
Westland, MI 48185
Phone (734) 427-5200

Interoperability endpoints

  • Direct secure messaging: mgeisinger@optimeyes.emadirect.md

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1366179798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41555 W TWELVE MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773103",
            "telephone_number": "248-675-0800",
            "fax_number": "248-675-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41555 W TWELVE MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773103",
            "telephone_number": "248-675-0800",
            "fax_number": "248-675-0545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35184 Central City Pkwy",
            "address_purpose": "LOCATION",
            "city": "Westland",
            "state": "MI",
            "postal_code": "481856215",
            "country_code": "US",
            "telephone_number": "734-427-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "744 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474053603",
            "country_code": "US",
            "telephone_number": "812-855-8436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEISINGER",
        "first_name": "MIRANDA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "49010056665",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004356A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.