Modern Eyes PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003868 Issued in MI

Legal business name

MODERN EYES PLLC

Practice address

51242 Westwood Dr
Macomb, MI 48042-4286

Phone

(586) 350-3141

NPI assigned

Jul 5, 2006

Organization subpart

No

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

Authorized official

Name

Jeffrey J Fitzmaurice, O.D.

Title

Member

Phone

(586) 350-3141

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Robert Deek, OD

  • Optometrist
  • Novi, MI
  • NPI 1366585234
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1700817376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51242 WESTWOOD DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480424286",
            "telephone_number": "586-350-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51242 WESTWOOD DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480424286",
            "telephone_number": "586-350-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN EYES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "FITZMAURICE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "586-350-3141",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "90-0E029260",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shakeela F Mirza, MD
• Lisa Mislevy, RDN
• Laura M Mistalski
• MJ Private Duty LLC (MJ Private Duty)
• Modern Dental Center
• Michael Mommsen
• Janell Montague
• Lisa M Montalto, LPC
• Melissa M Monteleone, CRNA
• Jennifer Moore

• Optometrist in Macomb, MI
• Providers in Macomb, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.