Great Lakes Eye Care PC
NPI 1922002708ActiveOrganization· Ophthalmology· Saint Joseph, MI
Ophthalmology in Saint Joseph, Michigan, registered in NPPES in June 2005. The authorized official on file is Brenda S. Jacks, Human Resources Director. Enrolled in Medicare as part b supplier - clinic/group practice and dme supplier - physician - ophthalmology.
Overview
| NPI | 1922002708 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 9, 2005 |
| Last updated in NPPES | Oct 15, 2026 |
| Certified by provider | Oct 15, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Ophthalmology Primary | 207W00000X | 4301046231 | 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 (IN); DME Supplier - Physician - Ophthalmology (MI); Part B Supplier - Clinic/Group Practice (MI) |
|---|
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