Port Huron Ophthalmology, PLLC
NPI 1376558122ActiveOrganization· Ophthalmology· Port Huron, MI
Ophthalmology in Port Huron, Michigan, registered in NPPES in July 2006. The authorized official on file is Brenda Jean Favero, Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1376558122 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 30, 2006 |
| Last updated in NPPES | Nov 24, 2021 |
| Certified by provider | Nov 24, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Ophthalmology Primary | 207W00000X | BF064615 | MI |
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 Part B Supplier - Clinic/Group Practice (MI) |
|---|
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