Northwest Ophthalmology,PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

NORTHWEST OPHTHALMOLOGY,PC

Practice address

26771 W 12 Mile Rd
Suite 105
Southfield, MI 48034-1539

Phone

(248) 352-8815

Fax

(248) 352-9157

NPI assigned

Oct 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gerald J Burke, M.D.NPI 1205814027

Title

President

Phone

(248) 352-8815

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Gerald J Burke, MD

  • Ophthalmology Physician
  • Southfield, MI
  • NPI 1205814027
  NPD (past) Authorized official

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1023205366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26771 W 12 MILE RD",
            "address_2": "SUITE 105",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341539",
            "telephone_number": "248-352-8815",
            "fax_number": "248-352-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26771 W 12 MILE RD",
            "address_2": "SUITE 105",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341539",
            "telephone_number": "248-352-8815",
            "fax_number": "248-352-9157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST OPHTHALMOLOGY,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-352-8815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1481927",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Northwest Surgical Associates PC
• Northwestern Psychiatry & Counseling Center PC
• Northwestern Rehabilitation Services LLC
• Northwestern Rehabilitation Services. LLC
• Northwestern RX, P.C.

• Ophthalmology Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.