GREAT LAKES EYE INSTITUTE – NPI #1427090976
Ophthalmology

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.

GREAT LAKES EYE INSTITUTE is an ophthalmologist located in SAGINAW, MI. NPPES has assigned the NPI number 1427090976 to GREAT LAKES EYE INSTITUTE on June 11, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207WX0107X from the Health Care Provider Taxonomy code set, which is classified as Ophthalmology, specializing in Retina Specialist

The NPI profile was last updated on Sep 29, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GREAT LAKES EYE INSTITUTE below.

NPI Profile for
GREAT LAKES EYE INSTITUTE

NPI Number
1427090976
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GREAT LAKES EYE INSTITUTE
Primary location
2393 SCHUST RD
SAGINAW, MI 48603-1334
Phone: (989) 793-2820 Fax: (989) 793-9132
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
FARHAD SHOKOOHI
OWNER
Phone: (989) 793-2820
Updated
Certification Date
Sep 29, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for GREAT LAKES EYE INSTITUTE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

See identifiers
DescriptionIssuerStateIdentifier
otherBLUE CARE NETWORKMI180G300890
otherBLUE CROSS BLUE SHIELDMI180G300890
otherFEDERAL EMPLOYEES PROGRAM BLUE CROSSMI180G300890
otherMEDICARE0G36036
otherRR MEDICAREMICA3610
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207WX0107X
- Ophthalmology / Retina Specialist (Primary)
MI 4301102705
207W00000X
- Ophthalmology
MI 43010040619

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.