Individual provider Active NPI

Danielle Woodbridge, O.D.

  • Optometrist
  • Grandville, MI
National Provider Identifier
1710335120
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004960 Issued in MI
Practice address
4070 Chicago Dr SW
Grandville, MI 49418-1258
Phone
(616) 531-3336
NPI assigned
May 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 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 4901004960 MI Primary

Addresses

Primary practice location

4070 Chicago Dr SW
Grandville, MI 49418-1258

Mailing address

4070 Chicago Dr SW
Grandville, MI 49418-1258
Phone (616) 531-3336

Other names 1

  • Danielle Seder Former name

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
I20160610001598 MI Practitioner - Optometry 2668762170 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Woodbridge Family Eye Care CurrentSince Apr 1, 2021 Accepting new patients

Locations

4070 Chicago Dr SW
Grandville, MI 49418
Phone (616) 531-3336

Organizations & group practices 1

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": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1710335120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 CHICAGO DR SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181258",
            "telephone_number": "616-531-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 CHICAGO DR SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181258",
            "telephone_number": "616-531-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODBRIDGE",
        "first_name": "DANIELLE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "SEDER",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.