Active NPI
Myeyedr Optometry of Michigan, LLC
Doing business as RX Optical
- Optometrist
- Plymouth, MI
National Provider Identifier
1386229805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- MYEYEDR OPTOMETRY OF MICHIGAN, LLC
- Doing business as
- RX Optical
- Practice address
- 44429 Ann Arbor Rd W
Plymouth, MI 48170-3907 - Phone
- (734) 416-0348
- Fax
- (734) 416-0827
- NPI assigned
- Mar 16, 2021
- Last updated
- May 27, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sue Downes
- Title
- Secretary
- Phone
- (703) 847-8899
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | NU | Primary |
Addresses
Primary practice location
44429 Ann Arbor Rd W
Plymouth, MI 48170-3907
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Other names 1
- RX Optical
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191014002048 | MI | Part B Supplier - Clinic/Group Practice | 7416288949 |
Receives reassigned benefits from 139 practitioners This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2325545 | Myeyedr Optometry of Michigan, LLC | Certificate of waiver | Jun 15, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Myeyedr Optometry Mi LLC
Other organizations with this tax ID 47
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Van Buren TWP, MI
- NPI 1225619760
Locations
44429 Ann Arbor Rd W
Plymouth, MI 48170
Phone (734) 416-0348
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Van Buren TWP, MI
- NPI 1427496488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615852800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1653609600000",
"number": "1386229805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8614 WESTWOOD CENTER DR FL 9",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822442",
"telephone_number": "703-847-8899",
"fax_number": "571-233-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44429 ANN ARBOR RD W",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481703907",
"telephone_number": "734-416-0348",
"fax_number": "734-416-0827"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MYEYEDR OPTOMETRY OF MICHIGAN, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-16",
"last_updated": "2022-05-27",
"certification_date": "2022-05-27",
"status": "A",
"authorized_official_last_name": "DOWNES",
"authorized_official_first_name": "SUE",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "703-847-8899"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "RX Optical",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "RX Optical",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.