Daniel Phillips, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003890 Issued in MI

Practice address

13330 Eureka Rd
Southgate, MI 48195-1310

Phone

(734) 285-2990

Fax

(734) 285-2712

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Illinois College of Optometry at Chicago, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Phillips Eye Care, P.L.L.C.

  • Optometrist
  • Southgate, MI
  • NPI 1689672396
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238025600000",
    "number": "1477557817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13330 EUREKA RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951310",
            "telephone_number": "734-285-2990",
            "fax_number": "734-285-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13330 EUREKA RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951310",
            "telephone_number": "734-285-2990",
            "fax_number": "734-285-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2009-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3450071",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "900H26664",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary E Petty-Dudley, M.D.
• Patricia Cody Petty
• Dawn Pfeiffer
• Wanda Denise Phelps
• Phillips Eye Care, P.L.L.C.
• Wilbur Eugene Phillips, O.D.
• Ivy Ting Pickell, LMSW
• Elizabeth Shannon Pierson
• Lanie Pifer
• Porsche Piggie, LIMITED LICENSE PSY

• 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 Mar 26, 2009; 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.