Debra E Bourdeau, O.D.
Individual provider Active NPI Optometrist · Commerce Township, MI
NPI 1790764173 · NPPES record last updated Jan 14, 2016
Key facts
- NPI
- 1790764173
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901004051 (MI)
- Practice address
- 3050 Union Lake Rd
Ste 3B
Commerce Township, MI 48382-4509 - Phone
- (248) 360-4300
- Fax
- (248) 360-4503
- NPI assigned
- Jan 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Doctors Alvarado, P.C.
Practice addresses (Care Compare)
212 W Silver Lake Rd
Fenton, MI 48430-2606
Phone (810) 629-3070
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090107000257 | MI | Practitioner - Optometry | 5698838324 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctors Alvarado, P.C. | Optometrist | Current |
Accepting new patients |
| E Gay Eye Care PLLC | Optometrist | Past |
Accepting new patients |
Locations
212 W Silver Lake Rd
Fenton, MI 48430
Phone (810) 629-3070
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901004051 | MI | Yes |
Addresses
Primary practice location
3050 Union Lake Rd
Ste 3B
Commerce Township, MI 48382-4509
Mailing address
3050 Union Lake Rd Ste 3B
Commerce Township, MI 48382-4563
Phone (248) 360-4300
Other providers in Commerce Township, MI
- Ravipal Singh Bhatti
- Billy L Cooper
- BJP2 Inc
- Keiva L Bland
- Bort-Swiss Orthopedic Supply
- Elizabeth Rose Bowlin
- Valerie Nicole Boyer
- Mary Beth Brady
- Casey Branach
- Roland Brandt
All providers in Commerce Township, MI · Optometrist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.