GREAT LAKES EYE CONSULTANTS PLC
NPI 1164552972
Ophthalmology in Traverse City, MI

Q: What is Great Lakes Eye Consultants Plc's NPI number?

The NPI number for Great Lakes Eye Consultants Plc is 1164552972. It was assigned to this organization in the NPPES registry on March 7, 2007.

Q: What is Great Lakes Eye Consultants Plc's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Active since March 07, 2007

872 MUNSON AVE, SUITE B, TRAVERSE CITY, MI 49686(231) 947-1690(231) 947-1692 Get Directions Write a Review

NPPES record last updated: May 22, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Great Lakes Eye Consultants Plc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES EYE CONSULTANTS PLC (NPI 1164552972) is a healthcare organization registered as an ophthalmology in Traverse City, Michigan and active in the NPI registry since March 2007. The organization lists Peter Fedor, Owner, as its authorized official.

NPPES Registry Identity

NPI1164552972

Entity TypeOrganization

Primary Taxonomy207W00000X

Legal Business NameGREAT LAKES EYE CONSULTANTS PLC

Location Address872 MUNSON AVE, SUITE BTraverse City, MI 49686

Mailing AddressPo Box 308Acme, MI 49610-0308 · (231) 947-1690 · Fax (231) 947-1692

Phone(231) 947-1690

Fax(231) 947-1692

Organization SubpartNo

Authorized OfficialPeter FedorOwner · (231) 947-1690

Enumeration DateMarch 7, 2007

Last NPPES UpdateMay 22, 2018

✔ NPI 1164552972 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in MI · 4301061885

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

872 MUNSON AVE, Traverse City, MI 49686

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Other Identifiers 4

Medicaid104609642MI

Medicaid104609651MI

Medicaid104609633MI

Medicaid104609660MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Care Network of Michigan, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Great Lakes Eye Consultants Plc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Great Lakes Eye Consultants Plc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Peter Fedor, MD

Ophthalmology

NPI 1821087560

872 MUNSON AVE SUITE B
Traverse City, MI 49686

(231) 947-1690

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Great Lakes Eye Consultants Plc's NPI number?

The NPI number for Great Lakes Eye Consultants Plc is 1164552972. It was assigned to this organization in the NPPES registry on March 7, 2007.

Where is Great Lakes Eye Consultants Plc located?

Great Lakes Eye Consultants Plc is located at 872 Munson Ave Suite B, Traverse City, MI 49686. The listed phone number is (231) 947-1690.

What is Great Lakes Eye Consultants Plc's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Great Lakes Eye Consultants Plc enrolled in Medicare?

Yes. Great Lakes Eye Consultants Plc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Great Lakes Eye Consultants Plc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Ophthalmology) reassigns their Medicare billing to Great Lakes Eye Consultants Plc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Great Lakes Eye Consultants Plc accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Care Network of Michigan, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 1 other insurer list Great Lakes Eye Consultants Plc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Great Lakes Eye Consultants Plc was last updated on May 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.