MAC OPTICAL (NPI# 1295868602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295868602 |
| Entity Type | Organization |
| Organization Name | MAC OPTICAL |
| Other Organization Name | DIAMOND OPTICAL CARE |
| Practice Address |
1425 N Leroy St Fenton MI 48430-2763 |
| Mailing Address |
1425 N. Leroy St Fenton MI 48430 |
| Practice Telephone | 8106292041 |
| Practice Fax Number | 8106299366 |
| Mailing Telephone | 8106645929 |
| Mailing Fax Number | 8106644915 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2011-02-09 |
| Authorized Official Name | MICHAEL G HENDRICKS (OWNER) |
| Authorized Official Telephone | 8106292041 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | MH003723 | MI | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3442900 | 05 | |
| MI | BLUE CROSS BLUE SHIELD | 0D41012 | 01 |
| MI | 943442900 | 05 | |
| MI | HAP | 0N11050 | 01 |
| MI | BLUE CROSS BLUE SHIELD | 900D41012 | 01 |
| Other Name | Type Code |
|---|---|
| Diamond Optical Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114114428 | Mac Optical | Optometrist | 1425 N Leroy St, Fenton, MI 48430-2763 | 2007-10-01 |
| Street Address |
1425 N LEROY ST |
| City | FENTON |
| State | MI |
| Zip Code | 48430-2763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255714150 | Gloria Stephanie Enriquez | Optometrist | 1425 N Leroy St, Fenton, MI 48430-2763 | 2015-07-09 |
| 1508260852 | Joseph M Leppek O.d. Pllc | Optometrist | 1425 N Leroy St, Fenton, MI 48430-2763 | 2014-10-15 |
| 1114114428 | Mac Optical | Optometrist | 1425 N Leroy St, Fenton, MI 48430-2763 | 2007-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1225515091 | Erica Anderson | Social Worker | 127 River St., Fenton, MI 48430 | 2018-07-25 |
| 1245767888 | Optimum Balance | Clinic/Center | 1537 N. Leroy Street, Suite D, Fenton, MI 48430 | 2017-05-14 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1366994410 | Intentional Wellbeing LLC | Psychologist | 1122 N. Leroy Rd, Suite A, Fenton, MI 48430 | 2016-10-25 |
| 1265801625 | Shawn Marie Gorkiewicz | Nurse Practitioner | 435 North Leroy, Fenton, MI 48430 | 2015-09-16 |
| 1972994226 | Carrie Hamilton | Physical Medicine & Rehabilitation | 102 N Adelaide St Ste B, Fenton, MI 48430 | 2015-02-09 |
| 1104222520 | Wellbridge of Fenton, LLC | Skilled Nursing Facility | 901 Pine Creek Drive, Fenton, MI 48430 | 2014-11-12 |
| 1225442759 | Joseph Matthew Leppek | Optometrist | 1425 N. Leroy St., Fenton, MI 48430 | 2014-06-12 |
| 1437569647 | Therapy Support Center LLC | Clinic/Center | 113 North River Street, Fenton, MI 48430 | 2014-04-28 |
| Find all providers in zip 48430 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| 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. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881155281 | Iris Eyecare PC | Optometrist | 403 S Leroy St, Fenton, MI 48430-2143 | 2019-03-28 |
| 1609223619 | Juan Alvarado Od Pllc | Optometrist | 212 W Silver Lake Rd, Fenton, MI 48430-2606 | 2016-05-19 |
| 1003223561 | Jamie Lynn Pancy | Optometrist | 3140 W Silver Lake Rd, Fenton, MI 48430-1321 | 2014-07-16 |
| 1225442759 | Joseph Matthew Leppek | Optometrist | 1425 N. Leroy St., Fenton, MI 48430 | 2014-06-12 |
| 1548566862 | E Doran Kasper Od PC | Optometrist | 234 W. Caroline St., Fenton, MI 48430-2807 | 2011-02-03 |
| 1225268451 | Bradley Elliott Borello | Optometrist | 532 Old Smizer Mill Rd, Fenton, MO 63026-3538 | 2009-07-22 |
| 1013046259 | James Charles Reeves | Optometrist | 521 N Leroy St, Fenton, MI 48430-2733 | 2007-03-05 |
| 1689754350 | Juan Alvarado | Optometrist | 1535 N Leroy St, Fenton, MI 48430-2791 | 2006-10-17 |
| 1134214216 | Daniel Gerard Puetz | Optometrist | 920 Brookwood Ctr, Fenton, MO 63026-3474 | 2006-10-04 |
| 1962432237 | Scott T Hussey | Optometrist | 480 Old Smizer Mill Rd, Fenton, MO 63026-3553 | 2006-07-03 |
| Find all providers in FENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.