P-Cor LLC
NPI 1104571074ActiveOrganization· Optometrist· Plymouth, MI
Optometrist in Plymouth, Michigan, registered in NPPES in February 2022. The authorized official on file is Shakia Tisdale, Credentialing/Privileging. Enrolled in Medicare as dme supplier - physician - optometrist.
Overview
| NPI | 1104571074 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 18, 2022 |
| Last updated in NPPES | Feb 18, 2022 |
| Certified by provider | Feb 4, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Optometrist (MI) |
|---|
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