GREAT LAKES EYE INSTITUTE
NPI 1992985840
Ophthalmology in Midland, MI

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

The NPI number for Great Lakes Eye Institute is 1992985840. It was assigned to this organization in the NPPES registry on November 8, 2007.

Q: What is Great Lakes Eye Institute's specialty?

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

Active since November 08, 2007

407 W WACKERLY ST, MIDLAND, MI 48640(989) 631-1345(989) 631-5129 Get Directions Write a Review

NPPES record last updated: August 17, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 17, 2018, Mar 17, 2018, Feb 17, 2018 (3 updates tracked since 2018).

On this page

About Great Lakes Eye Institute NPPES

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

GREAT LAKES EYE INSTITUTE (NPI 1992985840) is a healthcare organization registered as an ophthalmology in Midland, Michigan and active in the NPI registry since November 2007. The organization maintains a secondary practice location in Midland and lists Farhad K Shokoohi, Md/owner, as its authorized official.

NPPES Registry Identity

NPI1992985840

Entity TypeOrganization

Primary Taxonomy207W00000X

Legal Business NameGREAT LAKES EYE INSTITUTE

Location Address407 W WACKERLY STMidland, MI 48640-4727

Mailing Address2393 Schust RdSaginaw, MI 48603-1334 · (989) 793-2820 · Fax (989) 793-9132

Phone(989) 631-1345

Fax(989) 631-5129

Organization SubpartNo

Authorized OfficialFarhad K ShokoohiMd/owner · (989) 793-2820

Enumeration DateNovember 8, 2007

Last NPPES UpdateAugust 17, 20183 updates tracked since enumeration

✔ NPI 1992985840 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in MI · 4301040619

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 · License 4301040619 (MI)

407 W WACKERLY ST, Midland, MI 48640

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Secondary Practice Location 1

Location 1407 W Wackerly StMidland, MI 48640-4727 · Phone (989) 631-1345 · Fax (989) 631-5129

Other Identifiers 1

Other1427090976MI · Group Npi

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

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateMichiganEnrollment IDO20100930001804DME · Physician - OphthalmologyDue dateDecember 31, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

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 Institute's NPI number?

The NPI number for Great Lakes Eye Institute is 1992985840. It was assigned to this organization in the NPPES registry on November 8, 2007.

Where is Great Lakes Eye Institute located?

Great Lakes Eye Institute is located at 407 W Wackerly St, Midland, MI 48640. The listed phone number is (989) 631-1345.

What is Great Lakes Eye Institute's specialty?

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

Is Great Lakes Eye Institute enrolled in Medicare?

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

When is Great Lakes Eye Institute's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Michigan, Physician - Ophthalmology) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

When was this NPI record last updated?

The NPPES record for Great Lakes Eye Institute was last updated on August 17, 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.