Myeyedr Optometry of Michigan, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MYEYEDR OPTOMETRY OF MICHIGAN, LLC

Doing business as

RX Optical

Practice address

15204 Eureka Rd
Southgate, MI 48195-2653

Phone

(734) 282-9500

Fax

(734) 282-9588

NPI assigned

Mar 16, 2021

Last updated

May 27, 2022By the provider in NPPES

Organization subpart

No

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

Addresses

Other names 1

• RX Optical Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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.

• Robert Ray Baltierra

  • Optometrist
  • Dexter, MI
  • NPI 1013442094
  NPD
• Bashir D Tarraf, OD

  • Optometrist
  • Dearborn, MI
  • NPI 1831758358
  NPD

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": "1396320826",
    "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": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15204 EUREKA RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952653",
            "telephone_number": "734-282-9500",
            "fax_number": "734-282-9588"
        }
    ],
    "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "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"
        }
    ]
}

• Abdulqadir M Mussani, M.D.
• Henna Mussani, D.O.
• Solomon Muzher
• Lisa Marie Muzzin, BA, SST
• Cristian Lamar Manier Myatt
• Warner Myntti
• Desire N'Cho
• Mona Nabha
• Champa Nagappa, MD
• Mallory Christine Nagarah, D.O.

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

• 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.

Verify at the official NPI Registry.