PROMEDICA PHYSICIANS EYE CARE
NPI 1417355223
Optometrist in Monroe, MI
NPI Status: Active since December 10, 2014
Contact Information
1180 N MONROE ST
MONROE, MI
ZIP 48162
Phone: (734) 243-5300
Fax: (734) 243-3236
- Organization
- Optometrist
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 23D2292754
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-29-2027
About PROMEDICA PHYSICIANS EYE CARE
This page provides the complete NPI Profile along with additional information for Promedica Physicians Eye Care, a provider established in Monroe, Michigan operating as a Optometrist. The healthcare provider is registered in the NPI registry with number 1417355223 assigned on December 2014. The practitioner's primary taxonomy code is 152W00000X. The provider is registered as an organization and their NPI record was last updated 12 years ago. Promedica Physicians Eye Care operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Promedica Physicians Eye Care. The authorized official of this NPI record is Amy L Dywer (Credentialing Supervisor)
- NPI
- 1417355223
- Provider Legal Name
- PROMEDICA CENTRAL PHYSICIANS LLC
- Other Organization Name
- PROMEDICA PHYSICIANS EYE CARE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1180 N MONROE ST MONROE, MI 48162
- Location Phone
- (734) 243-5300
- Location Fax
- (734) 243-3236
- Mailing Address
- 1180 N MONROE ST MONROE, MI 48162
- Mailing Phone
- (734) 243-5300
- Mailing Fax
- (734) 243-3236
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-10-2014
- Last Update Date
- 12-10-2014
- Code Navigator
Promedica Physicians Eye Care is a medicare supplier with PTAN 20633909 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Ocular Prostheses or Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Conventional Contact Lenses or Prosthetic Lenses: Prosthetics Cataract Lenses.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License State
- MI
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | (MI) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20633909
- Accepts Medicare Assignment
- YES
- Specialities List
- Optometrist, Optician.
- Provider Type List
- PHYSICIAN – OPHTHALMOLOGY.
- Competitive Bidding
- NO
Supplies List
- Ocular Prostheses - Prosthetic eyes
- Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
- Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
- Prosthetic Lenses: Prosthetics Cataract Lenses - Cataract Eyeglasses
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D2292754
- Facility Type
- Physician Office
- Certificate Effective Date
- October 30, 2025
- Certificate Expiration Date
- October 29, 2027
- Laboratory Director
- A VINCENT SONGCO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Promedica Physicians Eye Care to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1417355223, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417355223, enumerated as an "organization" on December 10, 2014.
The provider is located at 1180 N MONROE ST MONROE, MI 48162 and the phone number is (734) 243-5300.
Optometrist with taxonomy code 152W00000X.
