Aliisa Bodker, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004376 Issued in MI

Practice address

108 N. Ridge Road
Canton, MI 48187-6601

Phone

(734) 725-2020

Fax

(734) 725-2040

NPI assigned

Feb 12, 2007

Last updated

Dec 11, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Blink Eyecare, PLLC

  • Optometrist
  • Canton, MI
  • NPI 1538567243
  Medicare reassignment NPD Authorized official
• Pearle Vision Inc

  • Optometrist
  • New Hudson, MI
  • NPI 1891840682
  NPD (past)
• Pearle Vision Inc

  dba Pearle Vision #C6672

  • Eyewear Supplier
  • Fairview Heights, IL
  • NPI 1982744033
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1982746616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N. RIDGE ROAD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481876601",
            "telephone_number": "734-725-2020",
            "fax_number": "734-725-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N. RIDGE ROAD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481876601",
            "telephone_number": "734-725-2020",
            "fax_number": "734-725-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODKER",
        "first_name": "ALIISA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blink Eyecare, PLLC
• Blossom Home Health Care Agency, Inc.
• Blueprint Therapy Center, LLC
• David Blum, M.D.
• Geethika Yadav Bodanapu
• James Bohdan
• Jafer Bohra
• Xavier Andres Bolivar
• Tina Lynn Boncher, OTR
• Alyssa Marie Bone, BCBA

• Optometrist in Canton, MI
• Providers in Canton, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.