Andersen Eye Prosthetics LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

ANDERSEN EYE PROSTHETICS LLC

Practice address

5161 Cardinal Park Dr
Saginaw, MI 48604

Phone

(989) 249-8853

Fax

(989) 249-8842

NPI assigned

Apr 1, 2011

Last updated

Mar 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alicia Oconnor

Title

Ceo

Phone

(989) 341-7170

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Andersen Eye Prosthetics LLC

  • Durable Medical Equipment & Medical Supplies
  • Livonia, MI
  • NPI 1174261218

  6305019266

  Same PAC ID
• Andersen Eye Prosthetics LLC

  • Ocularist
  • Grand Rapids, MI
  • NPI 1518232040

  6305019266

  Same PAC ID
• Andersen Eye Prosthetics, LLC

  • Ocularist
  • Detroit, MI
  • NPI 1235510892

  6305019266

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Andersen Eye Prosthetics LLC

  • Ocularist
  • Grand Rapids, MI
  • NPI 1518232040

  O20120330000069

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mike Bain

  • Ocularist
  • Saginaw, MI
  • NPI 1912086281
  NPD (past)

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1649569450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5649",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486030649",
            "telephone_number": "989-249-8853",
            "fax_number": "989-249-8842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5161 CARDINAL PARK DR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "48604",
            "telephone_number": "989-249-8853",
            "fax_number": "989-249-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSEN EYE PROSTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-01",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "989-341-7170"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andersen Eye Associates
• Andersen Eye Associates, PLC
• Andersen Eye Associates, PLC
• Andersen Eye Associates, PLC (Andersen Eye Associates)
• Andersen Eye Associates, PLC
• Andersen Eye Surgery Center, LLC
• Alexander Anderson, PA-C
• Andrea Maria Anderson
• Clyde Anderson III
• Cynthia Anderson

• Prosthetic/Orthotic Supplier in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Prosthetic/Orthotic Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.