GREAT LAKES EYE INSTITUTE NPI 1427090976

NPI Information

  • NPI: 1427090976
  • Provider Name: GREAT LAKES EYE INSTITUTE
  • Classification: Ophthalmology - 207WX0107X
  • Specialization: Retina Specialist
  • Entity Type: Organization
  • CLIA Number: 23D1059394
  • Address: 2393 SCHUST RD
    SAGINAW, MI
    ZIP 48603
  • Phone: (989) 793-2820

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NPI Details

GREAT LAKES EYE INSTITUTE is a retina specialist ophthalmology in Saginaw, MI. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. GREAT LAKES EYE INSTITUTE NPI is 1427090976. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2393 SCHUST RD
SAGINAW, MI
ZIP 48603-334
Phone: (989) 793-2820
Fax: (989) 793-9132

The provider's authorized official is Farhad Kayvan Shokoohi .
The authorized official title is Owner and has the following contact phone number (989) 793-2820.

The CLIA number assigned to this NPI record is 23D1059394 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/11/2006 and was last updated on 9/29/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207W00000XOphthalmology43010040619MICHIGANNo
2207WX0107XOphthalmologyRetina Specialist4301102705MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1180G300890OTHERMICHIGANFEDERAL EMPLOYEES PROGRAM BLUE CROSS
2180G300890OTHERMICHIGANBLUE CARE NETWORK
3180G300890OTHERMICHIGANBLUE CROSS BLUE SHIELD
40G36036OTHERMEDICARE
5CA3610OTHERMICHIGANRR MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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