Individual provider Active NPI

Amber Bowen, O.D.

  • Optometrist
  • Farmington Hills, MI
National Provider Identifier
1780971101
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004633 Issued in MI
Practice address
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312
Phone
(248) 436-4400
Fax
(810) 664-0220
NPI assigned
Jul 6, 2011
Last updated
Jul 19, 2024By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004633 MI Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312

Mailing address

833 Leonard St NW
Grand Rapids, MI 49504-4163
Phone (616) 458-7898

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
I20111005000520 MI Practitioner - Optometry 7719159227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

833 Leonard St NW B
Westside Optical
Grand Rapids, MI 49504-4163
Phone (616) 458-7978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Richard H Benninger MD PC Optometrist CurrentSince Aug 1, 2024 Accepting new patients
Westside Vision, LLC Optometrist CurrentSince Aug 14, 2024 Accepting new patients
Foster Family Holdings CurrentSince Aug 14, 2024 Accepting new patients
Michigan Street Optical Past Accepting new patients
Luxottica Retail North America Inc Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

833 Leonard St NW
Ste B
Grand Rapids, MI 49504
Phone (616) 458-7978

833 Michigan St NE
Ste 101
Grand Rapids, MI 49503
Phone (616) 459-1844

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1780971101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 LEONARD ST NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044163",
            "telephone_number": "616-458-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27777 INKSTER RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345312",
            "telephone_number": "248-436-4400",
            "fax_number": "810-664-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "AMBER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2011-07-06",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004633",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.