Individual provider Active NPI

Sarah Marie Diponio-Tulchinsky, O.D.

  • Optometrist
  • Plymouth, MI
National Provider Identifier
1720157712
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004390 Issued in MI
Practice address
487 Forest Ave
Plymouth, MI 48170-1721
Phone
(734) 414-1892
Fax
(734) 414-1962
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004390 MI Primary

Addresses

Primary practice location

487 Forest Ave
Plymouth, MI 48170-1721

Mailing address

487 Forest Ave
Plymouth, MI 48170-1721
Phone (734) 414-1892

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
I20090205000025 MI Practitioner - Optometry 6204990302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Family Eye Care PLLCGroup PAC ID 1759445851, 3 clinicians

Practice addresses (Care Compare)

253 N Main St
Plymouth, MI 48170-1238
Phone (734) 414-1892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Family Eye Care PLLC Optometrist CurrentSince Feb 4, 2009 Accepting new patients

Locations

253 N Main St
Plymouth, MI 48170
Phone (734) 414-1892

487 Forest Ave
Plymouth, MI 48170
Phone (734) 414-1892

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1720157712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "487 FOREST AVE",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701721",
            "telephone_number": "734-414-1892",
            "fax_number": "734-414-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 FOREST AVE",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701721",
            "telephone_number": "734-414-1892",
            "fax_number": "734-414-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPONIO-TULCHINSKY",
        "first_name": "SARAH",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.