Individual provider Active NPI

Lauren Elizabeth Roderick, O.D.

  • Optometrist
  • Detroit, MI
National Provider Identifier
1841545381
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005032 Issued in MI
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

Updated by the provider on May 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170508000755 MI Practitioner - Optometry 3173764990 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oakland Eye Care, P.C.Group PAC ID 5496859712, 5 clinicians

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 100Reported as group
Quality
96.99
Improvement activities
40
Cost
78.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005032MIMDOptometrist
1751SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Eye Care, P.C. CurrentSince May 7, 2018 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Mar 20, 2026 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Mar 20, 2026 Accepting new patients
University Physician Group CurrentSince May 1, 2017 Accepting new patients
Oakland Eye Care, P.C. CurrentSince May 7, 2018 Accepting new patients
DRS Eyecare Inc Optometrist PastSince Jul 8, 2013 Accepting new patients
DRS Eyecare, Inc. Optometrist PastSince Jul 8, 2013 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.

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

Verify at the official NPI Registry.