Bennett Optometry LLC
Organization Active NPI Optometrist · Ann Arbor, MI
NPI 1992792154 · NPPES record last updated Sep 13, 2019
Key facts
- NPI
- 1992792154
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- BME-0160973 (MI)
- Legal business name
- BENNETT OPTOMETRY LLC
- Practice address
- 117 S Main St
Ann Arbor, MI 48104-1902 - Phone
- (636) 200-4393
- Fax
- (734) 665-5522
- NPI assigned
- Oct 3, 2005
- Organization subpart
- No
Authorized official
- Name
- James J. Wachter, O.D.
- Title
- President/Owner
- Phone
- (636) 200-4393
Other NPIs on the same Medicare enrollment 19
Other NPIs with the same Medicare PAC ID 1
Practitioners 24
-
John E Akers, OD
-
Samuel S Estes, O.D.
-
Joshua Rabideau, OD
-
Toqua Saflo, OD
-
Aroob Saleem, OD
-
Daniel Joseph Vargovick, O.D.
-
Navneet Walia, OD
-
Jonathan Weston, O.D.
-
Colleen Gould Keiper, O.D.
-
Paul R Kennedy, OD
-
Robert Alex Nagy, O.D.
-
Gregory Popowitz, OD
-
Amy Elizabeth Bell, O.D.
-
Richard Tracy Carrigan, O.D.
-
Jamie Lynn McKenzie, O.D.
-
Kanwalpreet Kaur Pavone, O.D.
-
Diana Stewart, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040419000779 | MI | Part B Supplier - Clinic/Group Practice | 5193719367 |
Receives reassigned benefits from 24 practitioners 19 other NPIs on this enrollment Practice locations: East Lansing, MI; Three Rivers, MI; Tecumseh, MI; Saline, MI; Perry, MI; Okemos, MI; Novi, MI; Lansing, MI… |
National Provider Directory
Locations
117 S Main St
Ann Arbor, MI 48104
Phone (734) 665-5306
5700 Marsh Rd
Haslett, MI 48840
Phone (517) 339-4100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | |||
| Optometrist |
152W00000X | BME-0160973 | MI | Yes |
| Corneal and Contact Management Optometrist |
152WC0802X | |||
| Low Vision Rehabilitation Optometrist |
152WL0500X | |||
| Pediatric Optometrist |
152WP0200X | |||
| Sports Vision Optometrist |
152WS0006X | |||
| Vision Therapy Optometrist |
152WV0400X | |||
| Occupational Vision Optometrist |
152WX0102X |
Addresses
Primary practice location
117 S Main St
Ann Arbor, MI 48104-1902
Mailing address
117 S. Main St.
Ann Arbor, MI 48104
Phone (734) 665-5306
Other names
- Bennett Optometry
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.