Active NPI
Mattawan Family Eye Care PLC
- Optometrist
- Mattawan, MI
National Provider Identifier
1538940010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- MATTAWAN FAMILY EYE CARE PLC
- Practice address
- 52883 N Main St
Mattawan, MI 49071-8309 - Phone
- (269) 668-5558
- NPI assigned
- Oct 10, 2023
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Teresa Seim, OD
- Title
- Owner
- Phone
- (269) 668-5558
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Lansing, MI
- NPI 1003063306
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240212001114 | MI | Part B Supplier - Clinic/Group Practice | 4486097094 |
Receives reassigned benefits from 2 practitioners Practice locations: Mattawan, MI |
National Provider Directory
National Provider DirectorySpecialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
52883 N Main St
Mattawan, MI 49071-8309
Mailing address
52883 N Main St
Mattawan, MI 49071-8309
Phone (269) 668-5558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 10, 2023.
{
"created_epoch": "1696896000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696896000000",
"number": "1538940010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52883 N MAIN ST",
"city": "MATTAWAN",
"state": "MI",
"postal_code": "490718309",
"telephone_number": "269-668-5558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52883 N MAIN ST",
"city": "MATTAWAN",
"state": "MI",
"postal_code": "490718309",
"telephone_number": "269-668-5558"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MATTAWAN FAMILY EYE CARE PLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-10-10",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A",
"authorized_official_last_name": "SEIM",
"authorized_official_first_name": "TERESA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "269-668-5558",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mattawan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.