Matthew Black, OD
Optometrist in Comstock Park, MI. Individual provider (NPI-1).
NPI number1124512447
StatusActive
Last updated in NPPESSep 8, 2020
Details
- NPI
- 1124512447
- Entity type
- Individual (NPI-1)
- Name
- Matthew Black
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 20, 2018
- Certification date
- Sep 8, 2020
- Last updated
- Sep 8, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPTOMETRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 4901005112 | MI | Yes |
Practice location
3901 Alpine Ave NwComstock Park, MI 49321-8350
Phone 616-647-2213
Mailing address
3901 Alpine Ave NwComstock Park, MI 49321-8350
Phone 616-647-2213
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Optometrist providers in Comstock Park, MI
- Alpine Vision Center PLLCNPI 1225642408
- Keith R Moulds Od PCNPI 1275516155
- Keith Ronald Moulds, ODNPI 1487645065
- James P Patyi, ODNPI 1548345630
- Jeffrey Michael Thompson, O.D.NPI 1659434389
All 6 Optometrist providers in Comstock Park · All 125 providers in Comstock Park
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