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Deactivated NPI 1407883416 Deactivated / Inactive NPI Male Practitioner

Dr. Fredric Carl Devries , OD, FAAO

Optometrist • Grandville, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Fredric Devries has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 26, 2006
NPI Deactivation Date January 22, 2026
Total Practice Duration ~20 Years of Practice (2006 – 2026)

Professional Overview & Biography Verified Profile Summary

Dr. Fredric Devries, OD, FAAO was a registered Optometrist practicing in Grandville, MI. Throughout an active medical career spanning 20 years, Dr. Devries provided care at the practice location at 3050 IVANREST AVE SW until profile deactivation on 2026-01-22.

Historical Medicare Part B clinical services included examination of eye by ophthalmoscope with retinal drawing, examination of cornea and iris using lens device and slit lamp, established patient complete exam of visual system. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

3050 Ivanrest Ave Sw

Grandville, MI 494181400

Telephone 6165380150
Fax 6165383954
Associated Practice Facility / Clinic
🏢 Fredric C Devries Od Pc Facility NPI 1962592758

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Grandville, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.8 Yrs
State Avg: 21.1 Yrs
Regional Practice Density
17 Specialists

Practicing in Grandville, MI (2032 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
38.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92226 Examination of eye by ophthalmoscope with retinal drawing
327 159 $30.00 $18.71
92020 Examination of cornea and iris using lens device and slit lamp
239 231 $60.00 $20.86
92225 Examination of eye by ophthalmoscope with retinal drawing
227 116 $50.00 $21.30
92014 Established patient complete exam of visual system
136 129 $154.76 $78.21
92004 New patient complete exam of visual system
107 107 $129.00 $97.60
92012 Established patient problem focused exam of visual system
83 82 $129.00 $51.67
92225 Examination of eye by ophthalmoscope with retinal drawing
67 34 $50.00 $26.88
92226 Examination of eye by ophthalmoscope with retinal drawing
54 27 $30.00 $24.72
92020 Examination of cornea and iris using lens device and slit lamp
50 50 $60.00 $26.90
92004 New patient complete exam of visual system
28 28 $129.00 $125.33
92012 Established patient problem focused exam of visual system
22 22 $129.00 $84.65
92014 Established patient complete exam of visual system
21 21 $160.00 $123.26
76514 Ultrasound scan of cornea to determine thickness
14 14 $50.00 $12.20

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License MI 4901002219

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1073066569

Doctor of Optometry

NPI 1508214115

Doctor of Optometry

NPI 1629054127

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 22, 2026

Record deactivated on January 22, 2026

NPI Profile Active November 20, 2007

NPI status registered as active in NPPES database

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Updated Practice Location November 20, 2007

Registered at 3050 IVANREST AVE SW, GRANDVILLE, MI 494181400 (Tel: 6165380150)

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Updated Business Mailing Address November 20, 2007

Registered at 2711 BYRON STATION DR SW, BYRON CENTER, MI 493159458 (Tel: 6165830404)

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Provider Name / Credentials Updated November 20, 2007

Recorded as FREDRIC DEVRIES, O.D., F.A.A.O

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 20, 2007

Optometrist (License #4901002219 in MI)

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Initial NPI Registration & Enumeration June 26, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1407883416
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 26, 2006
Last Update: November 20, 2007
Deactivation Date: January 22, 2026

Mailing Address

2711 Byron Station Dr Sw

Byron Center, MI 493159458

Phone: 6165830404

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.