NPIMap

Organization Active NPI

P-Cor LLC

Doing business as Henry Ford Optimeyes

  • Optometrist
  • Bloomfield Hills, MI
National Provider Identifier
1508407982
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
P-COR LLC
Doing business as
Henry Ford Optimeyes
Practice address
1961 S. Telegraph Rd
Bloomfield Hills, MI 48302
Phone
(248) 972-2555
Fax
(248) 972-2585
NPI assigned
Oct 7, 2019
Last updated
Oct 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Authorized official

Name
Gail Elias
Title
VP of Operations
Phone
(248) 577-3624

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Eyewear Supplier 332H00000X NU

Addresses

Primary practice location

1961 S. Telegraph Rd
Bloomfield Hills, MI 48302

Mailing address

735 John R Rd Ste 150
Troy, MI 48083-5859
Phone (248) 588-9300

Other identifiers 1

IdentifierTypeStateIssuer
1720033343MedicaidMI

Other names 1

  • HENRY FORD OPTIMEYES Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040417000048 MI Part B Supplier - Clinic/Group Practice 9931194149 Receives reassigned benefits from 125 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lake Orion, MI; Madison Heights, MI; Milford, MI; Owosso, MI; Southfield, MI; Sterling Heights, MI; Taylor, MI; Troy, MI…
O20200109002865 MI DME Supplier - Physician - Optometrist 9931194149 Practice locations: Bloomfield Township, MI

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
Henry Ford Optimeyes1961 S Telegraph Rd, Bloomfield Township, MI 48302-0246(248) 972-2555 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1997

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1508407982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 JOHN R RD STE 150",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835859",
            "telephone_number": "248-588-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1961 S. TELEGRAPH RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "48302",
            "telephone_number": "248-972-2555",
            "fax_number": "248-972-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P-COR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "ELIAS",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "248-577-3624"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720033343",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HENRY FORD OPTIMEYES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.