Individual provider Active NPI

Andres Lambaria, O.D.

  • Optometrist
  • Davison, MI
National Provider Identifier
1508834821
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004063 Issued in MI
Practice address
1063 S State Rd Ste 3
Davison, MI 48423-1900
Phone
(810) 658-2020
Fax
(810) 658-5307
NPI assigned
Mar 11, 2006
Last updated
Oct 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004063 MI Primary

Addresses

Primary practice location

1063 S State Rd Ste 3
Davison, MI 48423-1900

Mailing address

2243 Abby CT
Davison, MI 48423-8387
Phone (810) 730-9790

Other identifiers 2

IdentifierTypeStateIssuer
900B519890OtherMIBLUE CROSS BLUE SHIELD
4475558MedicaidMI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040709000852 MI Practitioner - Optometry 0042298788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pco PCGroup PAC ID 4385746320, 3 clinicians

Practice addresses (Care Compare)

1063 S State Rd
3 Lambaria Eyecare Associates
Davison, MI 48423-1900
Phone (810) 658-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pco PC Optometrist CurrentSince Dec 1, 2006 Accepting new patients
Puresight Eyecare PC Optometrist CurrentSince Feb 6, 2022 Accepting new patients
James H English OD PC Optometrist PastSince Dec 1, 2006 Accepting new patients
Eyecare Associates Optometrist Past Accepting new patients

Locations

4067 E Court St
Ste 10
Burton, MI 48509
Phone (810) 230-1600

1063 S State Rd
Ste 3
Davison, MI 48423
Phone (810) 658-2020

1063 S State Rd
Ste 8A
Davison, MI 48423
Phone (810) 214-1421

1509 S State Rd
Ste E
Davison, MI 48423
Phone (810) 412-4183

8129 Miller Rd
Swartz Creek, MI 48473
Phone (810) 635-8191

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1508834821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2243 ABBY CT",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484238387",
            "telephone_number": "810-730-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1063 S STATE RD STE 3",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484231900",
            "telephone_number": "810-658-2020",
            "fax_number": "810-658-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBARIA",
        "first_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-11",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "900B519890",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4475558",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davison, MI

Sources for this page

Verify at the official NPI Registry.