Great Lakes Eye Institute

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

GREAT LAKES EYE INSTITUTE

Practice address

800 Woodside Ave
Bay City, MI 48708-5468

Phone

(989) 793-2820

Fax

(989) 755-1463

NPI assigned

May 4, 2020

Last updated

May 4, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michele Marie Heath

Title

Credentialing

Phone

(989) 793-2820

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Great Lakes Eye Institute

  • Ophthalmology Physician
  • Saginaw, MI
  • NPI 1063680791

  5799699534

  Same PAC ID
• Great Lakes Eye Institute

  • Ophthalmology Physician
  • Alma, MI
  • NPI 1346424272

  5799699534

  Same PAC ID
• Great Lakes Eye Institute

  • Retina Specialist (Ophthalmology) Physician
  • Saginaw, MI
  • NPI 1427090976

  5799699534

  Same PAC ID
• Great Lakes Eye Institute

  • Ophthalmology Physician
  • Frankenmuth, MI
  • NPI 1841474772

  5799699534

  Same PAC ID
• Great Lakes Eye Institute

  • Ophthalmology Physician
  • Saginaw, MI
  • NPI 1992985840

  5799699534

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Great Lakes Eye Institute4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Great Lakes Eye Institute

  • Ophthalmology Physician
  • Saginaw, MI
  • NPI 1063680791
  NPD tax ID
• Great Lakes Eye Institute

  • Ophthalmology Physician
  • Alma, MI
  • NPI 1346424272
  NPD tax ID
• Great Lakes Eye Institute

  • Ophthalmology Physician
  • Frankenmuth, MI
  • NPI 1841474772
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/gl98ei81

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588550400000",
    "number": "1003437823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2393 SCHUST RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031334",
            "telephone_number": "989-793-2820",
            "fax_number": "989-755-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WOODSIDE AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487085468",
            "telephone_number": "989-793-2820",
            "fax_number": "989-755-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES EYE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-04",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A",
        "authorized_official_last_name": "HEATH",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "989-793-2820"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427090976",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Great Lakes Bay Health Centers
• Great Lakes Bay Health Centers (Great Lakes Bay Health Centers Bayside Dental)
• Great Lakes Bay Health Centers
• Great Lakes Bay Health Centers
• Great Lakes Bay Health Centers
• Great Lakes Family Dental Group - Bay City PC
• Great Lakes Medical Center PLLC
• Great Lakes Pain Consult PLLC
• Great Lakes Pathway Mobility LLC
• Great Lakes Physician Resources PLLC

• Ophthalmology Physician in Bay City, MI
• Providers in Bay City, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.