Individual provider Active NPI

Hady H Srour, OD

  • Optometrist
  • Novi, MI
National Provider Identifier
1871223644
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005628 Issued in MI
Practice address
41555 W 12 Mile Rd
Novi, MI 48377-3103
Phone
(248) 675-0800
NPI assigned
Jun 14, 2022
Last updated
Sep 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005628 MI Primary

Addresses

Primary practice location

41555 W 12 Mile Rd
Novi, MI 48377-3103

Mailing address

41555 W 12 Mile Rd
Novi, MI 48377-3103
Phone (248) 675-0800

Other practice location 1

2800 W Big Beaver Rd Ste Q-111
Troy, MI 48084-3248
Phone (248) 639-4015

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
I20230611000088 MI Practitioner - Optometry 6507223211 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Detroit Mercy Optometrist CurrentSince Jan 10, 2025 Accepting new patients
Fortney Eyecare Associates Inc Optometrist CurrentSince Jun 7, 2023 Accepting new patients
University of Detroit Mercy CurrentSince Jan 10, 2025 Accepting new patients

Locations

23469 Michigan Ave
Dearborn, MI 48124
Phone (313) 565-5600

41555 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 675-0285

Organizations & group practices 3

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": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1871223644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41555 W 12 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773103",
            "telephone_number": "248-675-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41555 W 12 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773103",
            "telephone_number": "248-675-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 W Big Beaver Rd Ste Q-111",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480843248",
            "country_code": "US",
            "telephone_number": "248-639-4015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SROUR",
        "first_name": "HADY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.