Active NPI
Sadek Almothafer
- Optometrist
- Taylor, MI
National Provider Identifier
1669945796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901005810
- Practice address
- 23360 Eureka Rd
Taylor, MI 48180-5215 - Phone
- (734) 287-0024
- NPI assigned
- Jan 11, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901005810 | MI | Primary |
Addresses
Primary practice location
23360 Eureka Rd
Taylor, MI 48180-5215
Mailing address
23360 Eureka Rd
Taylor, MI 48180-5215
Phone (734) 287-0024
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240805001968 | MI | Practitioner - Optometry | 3274070578 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901005810 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visionworks, Inc | Optometrist | Current | Accepting new patients |
| Visionworks, Inc | Current | Accepting new patients |
Locations
3620 28th St SE
Kentwood, MI 49512
Phone (616) 512-0323
23360 Eureka Rd
Taylor, MI 48180
Phone (734) 287-0024
Organizations & group practices 2
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.
-
- Eyewear Supplier
- Simpsonville, SC
- NPI 1699571166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1669945796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23360 EUREKA RD",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481805215",
"telephone_number": "734-287-0024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23360 EUREKA RD",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481805215",
"telephone_number": "734-287-0024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALMOTHAFER",
"first_name": "SADEK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-11",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901005810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Taylor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.