Individual provider Active NPI

Sadek Almothafer

  • Optometrist
  • Taylor, MI
National Provider Identifier
1669945796
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005810 Issued in MI
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

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240805001968 MI Practitioner - Optometry 3274070578 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005810MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc Optometrist CurrentSince Aug 5, 2024 Accepting new patients
Visionworks, Inc CurrentSince Aug 5, 2024 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.

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

Verify at the official NPI Registry.