Organization Active NPI

Gregory D Popowitz PC

Doing business as Deltavision Optical

  • Optometrist
  • Okemos, MI
National Provider Identifier
1003804378
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003607 Issued in MI
Legal business name
GREGORY D POPOWITZ PC
Doing business as
Deltavision Optical
Practice address
2333 Jolly Rd
Okemos, MI 48864-3541
Phone
(517) 381-2000
Fax
(517) 381-2006
NPI assigned
Oct 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Gregory Darryl Popowitz, ODNPI 1336325414
Title
Owner
Phone
(517) 381-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 4901003607 MI Primary

Addresses

Primary practice location

2333 Jolly Rd
Okemos, MI 48864-3541

Mailing address

2333 Jolly Rd
Okemos, MI 48864-3541
Phone (517) 381-2000

Other identifiers 5

IdentifierTypeStateIssuer
203456MedicaidMI
OC36852OtherMIBCBSM
200000002542MedicaidMI
200000002541MedicaidMI
253368MedicaidMI

Other names 1

  • Deltavision Optical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Deltavision Optical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2333 Jolly Rd
Okemos, MI 48864
Phone (517) 381-2000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1003804378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 JOLLY RD",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643541",
            "telephone_number": "517-381-2000",
            "fax_number": "517-381-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 JOLLY RD",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643541",
            "telephone_number": "517-381-2000",
            "fax_number": "517-381-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY D POPOWITZ PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "POPOWITZ",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "DARRYL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-381-2000",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203456",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "OC36852",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200000002542",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200000002541",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253368",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deltavision Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.