Pcor LLC
NPI 1609042035ActiveOrganization· Optometrist· Grosse Pointe Woods, MI
Optometrist in Grosse Pointe Woods, Michigan, registered in NPPES in May 2008. The authorized official on file is Shakia Tisdale, Credentialing. Enrolled in Medicare as dme supplier - physician - optometrist.
Overview
| NPI | 1609042035 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 6, 2008 |
| Last updated in NPPES | Jul 10, 2026 |
| Certified by provider | Jul 10, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
| Eyewear Supplier (Equipment, not the service) | 332H00000X | — | 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 DME Supplier - Physician - Optometrist (MI) |
|---|
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