Individual provider Active NPI

Eric Thomas Anklin, OD

  • Optometrist
  • Tecumseh, MI
National Provider Identifier
1861580169
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003804 Issued in MI
Practice address
904 W Chicago Blvd
Ste a
Tecumseh, MI 49286-1298
Phone
(517) 423-2001
Fax
(517) 423-7030
NPI assigned
Oct 11, 2006
Last updated
Sep 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003804 MI Primary

Addresses

Primary practice location

904 W Chicago Blvd
Ste a
Tecumseh, MI 49286-1298

Mailing address

904 W Chicago Blvd Ste a
Tecumseh, MI 49286-1298
Phone (517) 423-7447

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
I20130626000167 MI Practitioner - Optometry 1254538309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

904 W Chicago Blvd
Suite a
Tecumseh, MI 49286-1298
Phone (517) 423-7447

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901003804MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
SVS Vision Inc Optometrist CurrentSince May 1, 2014 Accepting new patients
SVS Vision Inc Optometrist CurrentSince May 1, 2014 Accepting new patients
Eric T. Anklin, OD, PC Optometrist CurrentSince Feb 24, 2014 Accepting new patients
Dana E Gillin OD PC Optometrist PastSince Nov 17, 2008 Accepting new patients
Pearle Vision Inc Past Accepting new patients
Pearle Vision Inc Past Accepting new patients

Locations

118 Cass Ave
Mount Clemens, MI 48043
Phone (586) 464-1479

904 W Chicago Blvd
Tecumseh, MI 49286
Phone (517) 423-7447

904 W Chicago Blvd
Ste A
Tecumseh, MI 49286
Phone (517) 423-2001

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1861580169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 W CHICAGO BLVD STE A",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492861298",
            "telephone_number": "517-423-7447",
            "fax_number": "517-423-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W CHICAGO BLVD",
            "address_2": "STE A",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492861298",
            "telephone_number": "517-423-2001",
            "fax_number": "517-423-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANKLIN",
        "first_name": "ERIC",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tecumseh, MI

Sources for this page

Verify at the official NPI Registry.