Myeyedr Optometry of Michigan, LLC
Organization Active NPI Optometrist · Shelby Township, MI
NPI 1639723596 · NPPES record last updated May 27, 2022
Key facts
- NPI
- 1639723596
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- MYEYEDR OPTOMETRY OF MICHIGAN, LLC
- Practice address
- 48873 Hayes Rd
Shelby Township, MI 48315-4405 - Phone
- (586) 247-2121
- Fax
- (586) 532-7480
- NPI assigned
- Jul 30, 2019
- Organization subpart
- No
Authorized official
- Name
- Sue Downes
- Title
- Secratary
- Phone
- (703) 847-8899
Other NPIs with the same Medicare PAC ID 8
Practitioners 142
-
Carol Allen, OD
-
Jana Bazzoun, OD
-
Andrew Michael Bolles, O.D.
-
William Boras III, O.D.
-
Megan Brooks, O.D.
-
Heather Louise Cotter, O.D.
-
Fatima Elchawich, OD
-
Gincy George, O.D.
-
Lynda L Goeman, OD
-
Gerald E Hanna, OD
-
Diana L Haskins, O.D.
-
Steven Lynn Helms, O.D.
-
Robert C Huizenga, O D
-
Zachery Hulet, OD
-
Angela L Jammer, OD
-
Ning-Ju Juang, O.D
-
Todd William Lee, O.D.
-
Omar Mallah, OD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2301333 | Myeyedr Optometry of Michigan, LLC | Certificate of waiver | Mar 24, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191014002048 | MI | Part B Supplier - Clinic/Group Practice | 7416288949 | Receives reassigned benefits from 139 practitioners |
National Provider Directory
Locations
28522 Marlboro Ave
#A
Easton, MD 21601
Phone (410) 690-8844
920 Revolution St
Hvre de Grace, MD 21078
Phone (410) 939-2200
3275 Washtenaw Ave
Ann Arbor, MI 48104
Phone (269) 342-0003
229 Tecumseh St
Dundee, MI 48131
Phone (734) 529-8747
6143 Kalamazoo Ave SE
Grand Rapids, MI 49508
Phone (616) 554-7775
590 E 16th St
#20
Holland, MI 49423
Phone (616) 928-9640
3125 S State Rd
Ionia, MI 48846
Phone (616) 527-9279
7673 Georgetown Center Dr
Jenison, MI 49428
Phone (616) 457-2020
2067 S Drake Rd
Kalamazoo, MI 49006
Phone (269) 366-3664
1727 S Park St
Kalamazoo, MI 49001
Phone (269) 342-3910
2008 Washington Ave
Saint Joseph, MI 49085
Phone (269) 983-1303
3576 Alpine Ave NW
Walker, MI 49544
Phone (616) 784-4999
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
48873 Hayes Rd
Shelby Township, MI 48315-4405
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Other names
- MyEyeDr.
Other providers in Shelby Township, MI
- Bethany Anne Musallam
- Andy Musgrove
- Muslim Spiritual Care and Hospice Network
- Lauren Renee Myers
- Mariana Alicia Myers
- Jordan E Nacker
- Nicole Nagy
- Quinnkeela L Nash-El
- National Senior Care Network Inc
- Sarah Marie Nawrot
All providers in Shelby Township, MI · Optometrist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.