NPIMap

Organization Active NPI

Children'S Eye Care PC

  • Ophthalmology Physician
  • Detroit, MI
National Provider Identifier
1972874683
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CHILDREN'S EYE CARE PC
Practice address
3901 Beaubien St
Detroit, MI 48201-2119
Phone
(313) 745-3937
Fax
(313) 745-0401
NPI assigned
Jan 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Traci Fritz
Title
Practice Manager
Phone
(248) 254-8140

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary
Pediatric Ophthalmology and Strabismus Specialist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0110X

Addresses

Primary practice location

3901 Beaubien St
Detroit, MI 48201-2119

Mailing address

6689 Orchard Lake Road #297
West Bloomfield, MI 48322-3009
Phone (248) 254-8140

Other identifiers 1

IdentifierTypeStateIssuer
1534388MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070531000554 MI Part B Supplier - Clinic/Group Practice 0244338127 Receives reassigned benefits from 9 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dearborn, MI; West Bloomfield, MI; Detroit, MI; Clinton Township, MI

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Childrens Eye Care PC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

37555 Garfield Rd
Ste 105
Clinton Twp, MI 48036
Phone (586) 286-7227

42700 Garfield Rd
Ste 200
Clinton Twp, MI 48038
Phone (586) 532-3380

Practitioners & affiliated clinicians

Practitioners 8

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": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1972874683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6689 ORCHARD LAKE ROAD #297",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223009",
            "telephone_number": "248-254-8140",
            "fax_number": "248-254-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-3937",
            "fax_number": "313-745-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "FRITZ",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "248-254-8140"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1534388",
            "state": "MI"
        }
    ],
    "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 Apr 20, 2020; 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.