RIVERSIDE EYE CENTER PC
NPI 1174748081
Ophthalmology in East China, MI

Active since April 16, 2007CLIA Certified · 2 labs
4050 RIVER RD, EAST CHINA, MI 48054(810) 329-9045(810) 329-8732 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Riverside Eye Center Pc NPPES

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

RIVERSIDE EYE CENTER PC (NPI 1174748081) is a healthcare organization registered as an ophthalmology in East China, Michigan and active in the NPI registry since April 2007. The organization holds 2 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Kevin Hanton, Manager, as its authorized official.

NPPES Registry Identity

NPI1174748081
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameRIVERSIDE EYE CENTER PC
Location Address4050 RIVER RDEast China, MI 48054-2908
Mailing Address4050 River RdEast China, MI 48054-2908 · (810) 329-9045 · Fax (810) 329-8732
Fax(810) 329-8732
Organization SubpartNo
Authorized OfficialKevin HantonManager · (810) 385-7200
Enumeration DateApril 16, 2007
Last NPPES UpdateJuly 25, 2025
NPPES CertifiedJuly 25, 2025
✔ NPI 1174748081 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
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.
Also ListedOptometristTaxonomy 152W00000X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X · License 1146090001 (MI)
4050 RIVER RD, East China, MI 48054

Secondary Practice Locations 2

Location 117900 23 Mile Rd Ste 100Macomb, MI 48044-1161 · Phone (586) 416-1544 · Fax (586) 416-1545
Location 24656 24th AveFort Gratiot, MI 48059-3402 · Phone (810) 385-3600 · Fax (810) 385-0603

Other Identifiers 2

Other180G410170MI · Bcbs Pin
Other0741045MI · Bcbs Individual Pin

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted 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)

Riverside Eye Center Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Riverside Eye Center PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Ophthalmology
NPI 1609884220
4050 RIVER RD
East China, MI 48054
(810) 329-9045
✔ PECOS✔ Accepts MedicareSame address
Optometry
NPI 1104304328
4050 RIVER RD STE 1
East China, MI 48054
(810) 329-9045
✔ PECOS✔ Accepts MedicareSame address
Optometry
NPI 1073034757
33080 UTICA RD STE B
Fraser, MI 48026
(586) 296-7250
✔ PECOS✔ Accepts Medicare30 mi
Ophthalmology
NPI 1659582773
4717 SAINT ANTOINE ST
Detroit, MI 48201
(313) 577-8900
✔ PECOS✔ Accepts Medicare42 mi

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

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2039582

Riverside Eye Center · Fort Gratiot, MI
Active · expires Apr 11, 2028
CLIA Number23D2039582
Laboratory TypePhysician Office
Certificate Effective DateApril 12, 2026
Certificate Expiration DateApril 11, 2028
Laboratory DirectorEdward M. Balok
Laboratory Phone(810) 385-3600
Laboratory LocationRiverside Eye Center4656 24th Ave, Fort Gratiot, MI 48059
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2028407

Riverside Eye Center PC · East China, MI
Active · expires Mar 5, 2028
CLIA Number23D2028407
Laboratory TypePhysician Office
Certificate Effective DateMarch 6, 2026
Certificate Expiration DateMarch 5, 2028
Laboratory DirectorEdward M. Balok
Laboratory Phone(810) 329-9045
Laboratory LocationRiverside Eye Center PC4050 River Road, East China, MI 48054
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Riverside Eye Center PC's NPI number?

The NPI number for Riverside Eye Center PC is 1174748081. It was assigned to this organization in the NPPES registry on April 16, 2007.

Where is Riverside Eye Center PC located?

Riverside Eye Center PC is located at 4050 River Rd, East China, MI 48054. The listed phone number is (810) 329-9045.

What is Riverside Eye Center PC's specialty?

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

Is Riverside Eye Center PC enrolled in Medicare?

Yes. Riverside Eye Center PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Riverside Eye Center PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Riverside Eye Center PC, in Ophthalmology and Optometry. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Riverside Eye Center PC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Riverside Eye Center PC accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 2 other insurers list Riverside Eye Center PC 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 Riverside Eye Center PC was last updated on July 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.