Mark Andrew Stefani, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003690 Issued in MI

Practice address

32925 Groesbeck Highway
Fraser, MI 48026

Phone

(586) 293-8888

Fax

(586) 296-0726

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Fraser Optical Clinic, Inc.

  • Optometrist
  • Fraser, MI
  • NPI 1447326244
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1639292865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32925 GROESBECK HIGHWAY",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "48026",
            "telephone_number": "586-293-8888",
            "fax_number": "586-296-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32925 GROESBECK HIGHWAY",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "48026",
            "telephone_number": "586-293-8888",
            "fax_number": "586-296-0726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 N State St",
            "address_purpose": "LOCATION",
            "city": "Oscoda",
            "state": "MI",
            "postal_code": "487501715",
            "country_code": "US",
            "telephone_number": "989-739-2020",
            "fax_number": "989-739-9215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51026 Van Dyke Ave",
            "address_purpose": "LOCATION",
            "city": "Shelby Twp",
            "state": "MI",
            "postal_code": "483164436",
            "country_code": "US",
            "telephone_number": "586-254-9620",
            "fax_number": "586-884-7867",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "71150 Van Dyke Rd",
            "address_purpose": "LOCATION",
            "city": "Bruce Twp",
            "state": "MI",
            "postal_code": "480655436",
            "country_code": "US",
            "telephone_number": "586-752-9898",
            "fax_number": "586-372-8905",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "67205 S Main St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "MI",
            "postal_code": "480621919",
            "country_code": "US",
            "telephone_number": "586-727-7555",
            "fax_number": "586-248-5056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3602 15 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling Hts",
            "state": "MI",
            "postal_code": "483105355",
            "country_code": "US",
            "telephone_number": "586-977-9010",
            "fax_number": "586-413-7870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEFANI",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "58801",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900E06513",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "110955",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "4351",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404800",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindy Marie Smith, COTAL
• Lauren Danielle Snarski, RN
• Leigh Ellen Snyder, DDS
• Judith Marie Spence
• John W. Staszel, D.O.
• Leah Stefanou
• Susan Anderson Styf, LMSW
• Supplemental Health Care
• Elizabeth Sutherland, MD
• SVS Vision Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.