Blink Eyecare, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004376 Issued in MI

Legal business name

BLINK EYECARE, PLLC

Practice address

108 N. Ridge Rd
Canton, MI 48187-6678

Phone

(734) 725-2020

NPI assigned

Dec 11, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Aliisa Bodker, O.D.NPI 1982746616

Title

Owner/Optometrist

Phone

(734) 725-2020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aliisa Bodker, OD

  • Optometrist
  • Canton, MI
  • NPI 1982746616
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424304000000",
    "number": "1538567243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7960 HALLIE CT",
            "city": "SUPERIOR TWP",
            "state": "MI",
            "postal_code": "481987605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N. RIDGE RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481876678",
            "telephone_number": "734-725-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLINK EYECARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-11",
        "last_updated": "2015-02-19",
        "status": "A",
        "authorized_official_last_name": "BODKER",
        "authorized_official_first_name": "ALIISA",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "734-725-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.