Edward Granville Stewart, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004160 Issued in MI

Practice address

515 W 14TH St
Suite D
Traverse City, MI 49684-4059

Phone

(231) 947-2020

Fax

(231) 947-2002

NPI assigned

Dec 28, 2005

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Craftsmen Optical in.

  • Eyewear Supplier
  • Traverse City, MI
  • NPI 1568596898
  NPD (past)
• Luxottica Retail North America Inc

  • Eyewear Supplier
  • Midland, MI
  • NPI 1053457101
  NPD (past)
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1659358901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S GARFIELD AVE",
            "address_2": "SUITE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496865501",
            "telephone_number": "231-947-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W 14TH ST",
            "address_2": "SUITE D",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844059",
            "telephone_number": "231-947-2020",
            "fax_number": "231-947-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "EDWARD",
        "middle_name": "GRANVILLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944697888",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracey Ann Stevens, LMSW
• Margaret Stevenson, PA
• Nancy Stevenson, LMSW
• Robert F Stevenson, MD
• Stewart Family Eye Care PC
• Jonathon Burroughs Stewart, LMT
• Madison Lorraine Stewart
• Magdalena Anna Stewart, DNP, AGPCNP-BC
• Tate Stewart, BA
• Elizabeth Stier

• Optometrist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.