Individual provider Active NPI

James Bohdan

  • Optometrist
  • Canton, MI
National Provider Identifier
1760533293
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MI2602 Issued in MI
Practice address
42461 Ford Rd
Canton, MI 48187-3303
Phone
(734) 981-5820
Fax
(734) 981-7577
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MI2602 MI Primary

Addresses

Primary practice location

42461 Ford Rd
Canton, MI 48187-3303

Mailing address

42461 Ford Rd
Canton, MI 48187-3303
Phone (734) 981-5820

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
I20081113000055 MI Practitioner - Optometry 7315006897

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MI2602MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Without Limits LLC Optometrist CurrentSince Dec 6, 2022 Accepting new patients

Locations

42461 Ford Rd
Canton, MI 48187
Phone (734) 981-5820

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1760533293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42461 FORD RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873303",
            "telephone_number": "734-981-5820",
            "fax_number": "734-981-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42461 FORD RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873303",
            "telephone_number": "734-981-5820",
            "fax_number": "734-981-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHDAN",
        "first_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "MI2602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.