Active NPI
Lauren Elizabeth Roderick, O.D.
- Optometrist
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901005032
- Practice address
- 4717 Saint Antoine St
Detroit, MI 48201-1423 - Phone
- (313) 577-8900
- Fax
- (313) 577-0700
- NPI assigned
- Jul 20, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1751 | SC | |
| Optometrist | 152W00000X | 4901005032 | MI | Primary |
Addresses
Primary practice location
4717 Saint Antoine St
Detroit, MI 48201-1423
Mailing address
1560 E Maple Rd
Troy, MI 48083-1138
Phone (313) 577-8900
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5825 S Main St
Suite 100
Clarkston, MI 48346-2983
Phone (248) 620-3000
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.21 of 100
- Quality
- 96.99
- Improvement activities
- 40
- Cost
- 78.05
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901005032 | MI | MD | Optometrist |
| 1751 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakland Eye Care, P.C. | Current | Accepting new patients | |
| SVS Vision Inc | Optometrist | Current | Accepting new patients |
| SVS Vision Inc | Optometrist | Current | Accepting new patients |
| University Physician Group | Current | Accepting new patients | |
| Oakland Eye Care, P.C. | Current | Accepting new patients | |
| DRS Eyecare Inc | Optometrist | Past | Accepting new patients |
| DRS Eyecare, Inc. | Optometrist | Past | Accepting new patients |
Locations
5825 S Main St
Ste 100
Clarkston, MI 48346
Phone (248) 620-3000
15620 Hall Rd
Clinton Township, MI 48038
Phone (586) 676-9000
4717 Saint Antoine St
Detroit, MI 48201
Phone (313) 577-7614
4100 John R St
Detroit, MI 48201
Phone (313) 576-8530
22561 Gratiot Ave
Eastpointe, MI 48021
Phone (586) 350-2100
26400 W 12 Mile Rd
Ste 60
Southfield, MI 48034
Phone (248) 594-6702
1560 E Maple Rd
Ste 400
Troy, MI 48083
Organizations & group practices 8
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.
-
- Ophthalmology Physician
- Clarkston, MI
- NPI 1245332980
-
- Optometrist
- Mount Clemens, MI
- NPI 1194879023
-
- Ophthalmology Physician
- Clarkston, MI
- NPI 1922249937
-
- Optometrist
- Auburn Hills, MI
- NPI 1356858682
-
- Optometrist
- Irmo, SC
- NPI 1316919665
-
- Optometrist
- Columbia, SC
- NPI 1043427776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494374400000",
"number": "1841545381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1560 E MAPLE RD",
"city": "TROY",
"state": "MI",
"postal_code": "480831138",
"telephone_number": "313-577-8900",
"fax_number": "313-577-0700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4717 SAINT ANTOINE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011423",
"telephone_number": "313-577-8900",
"fax_number": "313-577-0700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODERICK",
"first_name": "LAUREN",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-20",
"last_updated": "2017-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SC",
"license": "1751",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901005032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.