Organization Active NPI

Mattawan Family Eye Care PLC

  • Optometrist
  • Mattawan, MI
National Provider Identifier
1538940010
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
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, ODNPI 1083716971
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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240212001114 MI Part B Supplier - Clinic/Group Practice 4486097094 Receives reassigned benefits from 2 practitioners
Practice locations: Mattawan, MI

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

NPPES NPI Registry

Primary 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.

Verify at the official NPI Registry.