Organization Active NPI

Michigan Eyecare Institute, P.C.

  • Ophthalmology Physician
  • Southfield, MI
National Provider Identifier
1962551531
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
207W00000X Issued in MI
Legal business name
MICHIGAN EYECARE INSTITUTE, P.C.
Practice address
29877 Telegraph Rd
100
Southfield, MI 48034-7658
Phone
(248) 352-2806
Fax
(248) 352-9590
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Authorized official

Name
Mrs. Destiny Hahn
Title
Administrator
Phone
(248) 352-2806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 207W00000X MI Primary

Addresses

Primary practice location

29877 Telegraph Rd
100
Southfield, MI 48034-7658

Mailing address

29877 Telegraph Rd Ste 100
Southfield, MI 48034-7658
Phone (248) 352-2806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040901001305 MI Part B Supplier - Clinic/Group Practice 4284625971 Receives reassigned benefits from 7 practitioners
Practice locations: Southfield, MI; Livonia, MI; Dearborn, MI
O20100930086375 MI DME Supplier - Physician - Optometrist 4284625971 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Southfield, MI

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

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

Locations

36300 Schoolcraft Rd
Ste E101
Livonia, MI 48150

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1962551531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29877 TELEGRAPH RD STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347658",
            "telephone_number": "248-352-2806",
            "fax_number": "248-352-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29877 TELEGRAPH RD",
            "address_2": "100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347658",
            "telephone_number": "248-352-2806",
            "fax_number": "248-352-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN EYECARE INSTITUTE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "DESTINY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-352-2806",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "207W00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.