NPIMap

Organization Active NPI

Dietrich PC

Doing business as Harrisville Eye Care

  • Optometrist
  • Harrisville, MI
National Provider Identifier
1497173322
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004764 Issued in MI
Legal business name
DIETRICH PC
Doing business as
Harrisville Eye Care
Practice address
300 N State St
Harrisville, MI 48740-9693
Phone
(989) 724-7440
Fax
(989) 724-7531
NPI assigned
Mar 28, 2014
Last updated
Jul 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Authorized official

Name
Mrs. Lois Jean Westergard
Title
Office Manager
Phone
(989) 724-7440

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004764 MI Primary
Vision Therapy Optometrist 152WV0400X 4901004764 MI

Addresses

Primary practice location

300 N State St
Harrisville, MI 48740-9693

Mailing address

300 N State St
Harrisville, MI 48740-9693
Phone (989) 724-7440

Other names 1

  • Harrisville Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140430001978 MI Part B Supplier - Clinic/Group Practice 8426281379 Receives reassigned benefits from 1 practitioner
Practice locations: Harrisville, MI
O20140602002652 MI DME Supplier - Physician - Optometrist 8426281379 Practice locations: Harrisville, MI

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Dietrich PC300 N State St, Harrisville, MI 48740-9693(989) 724-7440 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Apr 1, 2014

National Provider Directory

National Provider Directory

Locations

300 N State St
Harrisville, MI 48740
Phone (989) 724-7440

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1497173322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N STATE ST",
            "city": "HARRISVILLE",
            "state": "MI",
            "postal_code": "487409693",
            "telephone_number": "989-724-7440",
            "fax_number": "989-724-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N STATE ST",
            "city": "HARRISVILLE",
            "state": "MI",
            "postal_code": "487409693",
            "telephone_number": "989-724-7440",
            "fax_number": "989-724-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIETRICH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-28",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "WESTERGARD",
        "authorized_official_first_name": "LOIS",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-724-7440",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004764",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "MI",
            "license": "4901004764",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harrisville Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harrisville Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrisville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; 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.