Trevor Graham Bet, OD
Individual provider Active NPI Optometrist · Davison, MI
NPI 1861912248 · NPPES record last updated Sep 12, 2023
Key facts
- NPI
- 1861912248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901005729 (MI)
- Practice address
- 1063 S State Rd Ste 3
Davison, MI 48423-1900 - Phone
- (810) 658-2020
- NPI assigned
- Jun 26, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|---|
| I20230901002050 | MI | Practitioner - Optometry | 9638439375 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TA2588 | MD | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeffrey L. Morer, OD, PC | Optometrist | Current |
Accepting new patients |
| Sunrise Eye Care PA | Optometrist | Past | Accepting new patients |
Locations
120 N Washington Sq
Ste 300
Lansing, MI 48933
Phone (317) 510-0758
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TA2588 | MD | |
| Optometrist | 152W00000X | 4901005729 | MI | Yes |
Addresses
Primary practice location
1063 S State Rd Ste 3
Davison, MI 48423-1900
Mailing address
1418 Eden Gardens Dr
Fenton, MI 48430-9605
Other providers in Davison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2023. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.