DR. REGINALD DEAN GRANDISON (O.D.) – Optometrist, NPI 1790723609

DR. REGINALD DEAN GRANDISON (O.D.) is a healthcare provider. based in Southfield, Michigan. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 4901003700 (MI). The NPI Number for DR. REGINALD DEAN GRANDISON (O.D.) is 1790723609

Main info

Male
Sole Proprietor
32 Years Of Experience
Accepts Medicare Assignment
Name
DR. REGINALD DEAN GRANDISON (O.D.)
NPI
1790723609
Phone
(248) 443-8089
Address
23832 SOUTHFIELD RD
Enumeration Date
3 June 2006
Last Update Date
3 January 2008

Doctor Profile

Medical School Name
NEW ENGLAND COLLEGE OF OPTOMETRY
Secondary Phone
8889646681
Graduation Year
1994 (32 years ago)
PAC ID
9739191487
Group Practice PAC ID
7719870807
Professional Enrollment ID
I20060620000116
Address ID
MI489331617LA120XXSQXX405
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,212 OPTOMETRY in MI

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Provider Addresses for DR. REGINALD DEAN GRANDISON (O.D.)

  • Southfield Road, Detroit, Wayne County, Michigan, 48075:48235, United States

    SOUTHFIELD, MI 480758017

    Phone: (248) 443-8089

    Fax: (313) 865-1867

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $358.

Total Amount is formed as General ($358) + Research ($0) + Ownership ($0) = $358.

Last reported payment date: 2024-09-25 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($121).

Total Amount

$358

General + Research + Ownership

Payments

3

Total payment records

General Amount

$358

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-25

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-06-20

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060620000116IOptometryMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92012Established patient problem focused exam of visual system650502$0
92004New patient complete exam of visual system463463$0
92014Established patient complete exam of visual system198193$0
View full utilization report →

Insurance plans in this area (ZIP 48075)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719870807View full group profile
NameSpecialtyState
-IN
O P T O M E T R YPA
O P T O M E T R YIN
O P T O M E T R YCT
O P T O M E T R YNJ
O P T O M E T R YVA
O P T O M E T R YNC
O P T O M E T R YRI
O P T O M E T R YKY
O P T O M E T R YPA

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. REGINALD DEAN GRANDISON (O.D.)?
DR. REGINALD DEAN GRANDISON (O.D.) — NPI 1790723609 — is the standard way to identify this listing.
Does the file indicate DR. REGINALD DEAN GRANDISON (O.D.) is practicing under active NPI?
Directory data currently reports DR. REGINALD DEAN GRANDISON (O.D.) as active.
What taxonomy line describes DR. REGINALD DEAN GRANDISON (O.D.)?
For research purposes, treat DR. REGINALD DEAN GRANDISON (O.D.) as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
Where is DR. REGINALD DEAN GRANDISON (O.D.) based?
DR. REGINALD DEAN GRANDISON (O.D.) is tied to Southfield, Michigan in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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