Organization Active NPI

Soave Eye Care PLLC

  • Optometrist
  • Traverse City, MI
National Provider Identifier
1689274516
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SOAVE EYE CARE PLLC
Practice address
522 S Garfield Ave Ste a
Traverse City, MI 49686-3485
Phone
(231) 947-9500
Fax
(231) 947-2767
NPI assigned
Oct 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Authorized official

Name
Scott Soave, ODNPI 1629302468
Title
Owner/Provider
Phone
(231) 947-6767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

522 S Garfield Ave Ste a
Traverse City, MI 49686-3485

Mailing address

1040 S Garfield Ave
Traverse City, MI 49686-3434
Phone (231) 947-6767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210107001362 MI Part B Supplier - Clinic/Group Practice 6103239306 Receives reassigned benefits from 2 practitioners
Practice locations: Traverse City, MI

National Provider Directory

National Provider Directory

Locations

522 S Garfield Ave
Ste A
Traverse City, MI 49686
Phone (231) 947-9500

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605830400000",
    "number": "1689274516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 S GARFIELD AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863434",
            "telephone_number": "231-947-6767",
            "fax_number": "231-947-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 S GARFIELD AVE STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863485",
            "telephone_number": "231-947-9500",
            "fax_number": "231-947-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOAVE EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "SOAVE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "231-947-6767",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.