SAINT JOSEPH VISION THERAPY LLC
NPI 1669937926
Optometrist - Vision Therapy in Saint Joseph, MI

NPI Status: Active since January 31, 2019

Contact Information

2908 DIVISION ST
SAINT JOSEPH, MI
ZIP 49085
Phone: (269) 983-3309
Fax: (269) 983-0846

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  • Organization
  • Optometrist
  • Vision Therapy
  • CLIA Number: 23D0377514
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-31-2026

About SAINT JOSEPH VISION THERAPY LLC

This page provides the complete NPI Profile along with additional information for Saint Joseph Vision Therapy Llc, a provider established in Saint Joseph, Michigan operating as a Optometrist, focusing in vision therapy . The healthcare provider is registered in the NPI registry with number 1669937926 assigned on January 2019. The practitioner's primary taxonomy code is 152WV0400X. The provider is registered as an organization and their NPI record was last updated 7 years ago. Saint Joseph Vision Therapy Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mr. Charles Fortenbacher (Cfo)

NPI
1669937926
Provider Name
SAINT JOSEPH VISION THERAPY LLC
Entity Type
Organization
Location Address
2908 DIVISION ST SAINT JOSEPH, MI 49085
Location Phone
(269) 983-3309
Location Fax
(269) 983-0846
Mailing Address
2908 DIVISION ST SAINT JOSEPH, MI 49085
Mailing Phone
(269) 983-3309
Mailing Fax
(269) 983-0846
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-31-2019
Last Update Date
01-31-2019
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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 Vision Therapy

Taxonomy Code
152WV0400X
Type
Eye and Vision Services Providers
Taxonomy Description
Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions.

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)
1152WS0006XEye and Vision Services Providers

Optometrist
Sports Vision

 

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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. CHARLES FORTENBACHER

Authorized Official Title
CFO
Authorized Official Phone
(269) 449-1513

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
4901002693OTHER (01)MIOPTOMETRY LICENSE
900A165280OTHER (01)MIBLUE CROSS BLUE SHIELD OF MICHIGAN

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
23D0377514
Facility Type
Physician Office
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
MUKUND R. SHAH
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Saint Joseph Vision Therapy Llc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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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 1669937926, we treat the final digit (6) 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 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 6).

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.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
9
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
3
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
9
Unchanged
Pos 9
2
Doubled → 4
Check
6
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 6 → 12 → 3 9 → 18 → 9 7 → 14 → 5 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 2 + 9 + 1 + 8 + 3 + 1 + 4 + 9 + 4 + 24 = 74

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 74 is 80. The difference is the calculated check digit.

80 - 74 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1669937926.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Optometrist
2908 DIVISION ST
SAINT JOSEPH, MI 49085

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1669937926, enumerated as an "organization" on January 31, 2019.

The provider is located at 2908 DIVISION ST SAINT JOSEPH, MI 49085 and the phone number is (269) 983-3309.

Optometrist with taxonomy code 152WV0400X and a focus in Vision Therapy.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.