NPIMap

Organization Active NPI

P-Cor, LLC

  • Optometrist
  • Detroit, MI
National Provider Identifier
1922428887
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
P-COR, LLC
Practice address
400 Renaissance Ctr Ste 1402
Detroit, MI 48243-1502
Phone
(313) 324-8100
Fax
(313) 567-2568
NPI assigned
Apr 18, 2014
Last updated
Jan 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Authorized official

Name
Gail Elias
Title
VP
Phone
(248) 577-3624

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

400 Renaissance Ctr Ste 1402
Detroit, MI 48243-1502

Mailing address

735 John R Rd Ste 150
Troy, MI 48083-5859
Phone (248) 588-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140827002922 MI DME Supplier - Physician - Optometrist 9931194149 Practice locations: Detroit, MI

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Henry Ford Optimeyes400 Renaissance Ctr, Detroit, MI 48243-1502(313) 324-8100 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1997

National Provider Directory

National Provider Directory
Tax ID family
Pcor - LLC26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1922428887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 JOHN R RD STE 150",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835859",
            "telephone_number": "248-588-9300",
            "fax_number": "248-588-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RENAISSANCE CTR STE 1402",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482431502",
            "telephone_number": "313-324-8100",
            "fax_number": "313-567-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P-COR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-18",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "ELIAS",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "248-577-3624"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "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 Jan 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.