Daniel G Balcueva, O.D.
Individual provider Active NPI Optometrist · Troy, MI
NPI 1659636017 · NPPES record last updated Sep 15, 2015
Key facts
- NPI
- 1659636017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901004830 (MI)
- Practice address
- 735 John R Rd
Troy, MI 48083-5856 - Phone
- (248) 544-3290
- Fax
- (248) 528-4040
- NPI assigned
- Jul 11, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 24
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- P-Cor LLC
Practice addresses (Care Compare)
35184 Central City Pkwy
Westland, MI 48185-6215
Phone (734) 427-5200
735 John R Rd
Suite 150
Troy, MI 48083-5859
Phone (248) 951-0000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141106000208 | MI | Practitioner - Optometry | 3173776382 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18003721 | IN | MD | Optometrist |
| 4901004830 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pcor, LLC | Optometrist | Current |
Accepting new patients |
| Pcor LLC | Optometrist | Current |
Accepting new patients |
| Eyecare Indiana II, P.C. | Optometrist | Past | Accepting new patients |
Locations
1961 S Telegraph Rd
Ste 101
Bloomfield Township, MI 48302
Phone (248) 972-2555
27903 23 Mile Rd
Chesterfield, MI 48051
Phone (586) 598-3935
33100 S Gratiot Ave
Clinton Twp, MI 48035
Phone (586) 294-0120
3271 Union Lake Rd
Commerce Twp, MI 48382
Phone (248) 360-0121
400 Renaissance Ctr
Ste 140
Detroit, MI 48243
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
38487 W 10 Mile Rd
Farmington Hills, MI 48335
Phone (248) 477-9300
22500 Haggerty Rd
Farmington Hills, MI 48335
Phone (248) 477-9300
4281 24th Ave
Fort Gratiot, MI 48059
Phone (810) 385-4000
15401 E Jefferson Ave
Grosse Pointe Park, MI 48230
Phone (313) 824-2401
1376 S Lapeer Rd
#A
Lake Orion, MI 48360
Phone (248) 693-3380
655 W 13 Mile Rd
Madison Hts, MI 48071
Phone (248) 577-3616
516 Highland Ave
Milford, MI 48381
Phone (248) 577-3616
504 N Telegraph Rd
Monroe, MI 48162
Phone (734) 243-2020
40895 Ann Arbor Rd E
Plymouth, MI 48170
Phone (734) 233-6300
2025 25 Mile Rd
Shelby Township, MI 48316
Phone (248) 651-3937
29350 Southfield Rd
Southfield, MI 48076
Phone (248) 569-9017
44987 Schoenherr Rd
Sterling Hts, MI 48313
Phone (586) 247-5910
22395 Eureka Rd
Taylor, MI 48180
Phone (248) 661-5100
735 John R Rd
Ste 150
Troy, MI 48083
Phone (248) 588-9300
735 John R Rd
Troy, MI 48083
Phone (248) 544-3290
35184 Central City Pkwy
Westland, MI 48185
Phone (734) 427-5200
Interoperability endpoints
- dbalcueva371746@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18003721 | IN | |
| Optometrist | 152W00000X | 4901004830 | MI | Yes |
Addresses
Primary practice location
735 John R Rd
Troy, MI 48083-5856
Mailing address
655 W 13 Mile Rd
Madison Heights, MI 48071-1850
Phone (248) 588-9300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201202570 | Medicaid | IN | |
| 1659636017 | Medicaid | MI |
Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2015. 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.
- Order and Referring (CMS).
- 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.