Organization Active NPI

Restoration Eye Care PLLC

  • Ophthalmology Physician
  • Wyoming, MI
National Provider Identifier
1720761943
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RESTORATION EYE CARE PLLC
Practice address
2225 Main St SW Ste 140
Wyoming, MI 49519-9697
Phone
(616) 287-5495
NPI assigned
Aug 14, 2023
Last updated
Apr 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Trevor Smith, MDNPI 1376957043
Title
Owner/Founder
Phone
(616) 510-5858

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
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

2225 Main St SW Ste 140
Wyoming, MI 49519-9697

Mailing address

2225 Main St SW Ste 140
Wyoming, MI 49519-9697
Phone (616) 323-2002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231115003154 MI Part B Supplier - Clinic/Group Practice 8123475969 Receives reassigned benefits from 2 practitioners
Practice locations: Wyoming, MI

National Provider Directory

National Provider Directory

Locations

2225 Main St SW
Ste 140
Wyoming, MI 49519
Phone (616) 323-2002

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1720761943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 MAIN ST SW STE 140",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199697",
            "telephone_number": "616-323-2002",
            "fax_number": "616-699-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 MAIN ST SW STE 140",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199697",
            "telephone_number": "616-287-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-14",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "OWNER/FOUNDER",
        "authorized_official_telephone_number": "616-510-5858",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.