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ANTHONY SESTO O.D.
NPI 1699128801
Optometrist in Saint Clair Shores, MI

Active since July 22, 2016PECOS EnrolledAccepts Medicare Assignment
99.6/100
CMS Quality Rating
23620 HARPER AVE, SAINT CLAIR SHORES, MI 48080(586) 775-6733(586) 775-0397 Get Directions Write a Review

NPPES record last updated: March 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 18, 2026, Sep 13, 2022, Feb 18, 2021 and 4 more (7 updates tracked since 2016).

About Anthony Sesto O.d. NPPES

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

ANTHONY SESTO O.D. (NPI 1699128801) is an individual optometrist in Saint Clair Shores, Michigan, licensed in Michigan (4901004977) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Ferris State College - College Of Optometry (2016).

NPPES Registry Identity

NPI1699128801
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameANTHONY SESTOCredential: O.D.
Location Address23620 HARPER AVESaint Clair Shores, MI 48080-1448
Mailing Address23620 Harper AveSaint Clair Shores, MI 48080-1448 · (586) 775-6733 · Fax (586) 775-0397
Phone(586) 775-6733
Fax(586) 775-0397
Sole ProprietorNo
Medical School CMSFerris State College - College Of OptometryGraduated 2016
Enumeration DateJuly 22, 2016
Last NPPES UpdateMarch 18, 20267 updates tracked since enumeration
NPPES CertifiedMarch 18, 2026
✔ NPI 1699128801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in MI · 4901004977
Definition
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.
23620 HARPER AVE, Saint Clair Shores, MI 48080
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1137 S Livernois RdRochester Hills, MI 48307-1837 · Phone (248) 652-0600 · Fax (248) 652-2661
Location 247093 Hayes RdShelby Township, MI 48315-4909 · Phone (586) 737-4733 · Fax (586) 737-0716
Location 336838 Ryan RdSterling Heights, MI 48310-4455 · Phone (586) 978-7232 · Fax (586) 978-2745

Other Identifiers 2

Medicaid1699128801MI
Other180G410170MI · Bcbs Group

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Anthony Sesto O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870889264
PECOS Enrollment IDI20160912001080
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
140 services128 patients
Microfluid analysis of tears 83861
Microfluid analysis of tears involves collecting a small tear sample to examine its composition. This procedure can help detect health issues like dry eye disease, inflammation, or other eye conditions. It's a non-invasive, painless method for monitoring eye health.
116 services46 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
80 services79 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
59 services58 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
56 services45 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
45 services38 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48080 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

99.6/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability82
Improvement Activities40

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%28 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
100%195 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%466 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
1%2,247 patients1/55-star benchmark: 100%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
100%78 patients5/55-star benchmark: 100%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
1%2,247 patients1/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…
0%2,247 patients1/55-star benchmark: 77%
Tobacco Use and Help with Quitting Among Adolescents
The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user
100%438 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier21 claims21 services$56.36 avg. paid by Medicare
Anti-reflective coating, per lens V2750
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier12 claims24 services$16.56 avg. paid by Medicare
Lens, polycarbonate or equal, any index, per lens V2784
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier24 claims44 services$38.89 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NORMANDY OPTICAL COMPANY, INC
Optometrist
23620 HARPER AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 775-6733
MS. HANNAH CHRISTINE LONG
Optometrist
23620 HARPER AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (248) 836-8050
EMERSON GRACE LANKFORD
Optometrist
23620 HARPER AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 775-6733
MADELINE MICHELLE SIMON OD
Optometrist
23620 HARPER AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 331-0794
CALVIN HABBA OD
Optometrist
23620 HARPER AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 775-6733

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 Anthony Sesto's NPI number?

The NPI number for Anthony Sesto is 1699128801. It was assigned to this individual provider in the NPPES registry on July 22, 2016.

Where is Anthony Sesto located?

Anthony Sesto practices at 23620 Harper Ave, Saint Clair Shores, MI 48080. The listed phone number is (586) 775-6733.

What is Anthony Sesto's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Anthony Sesto enrolled in Medicare?

Yes. Anthony Sesto is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Anthony Sesto accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 7 other insurers list Anthony Sesto 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 Anthony Sesto was last updated on March 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.