Individual provider Active NPI

Alan M Mindlin, MD

  • Ophthalmology Physician
  • Bloomfield Hills, MI
National Provider Identifier
1053302851
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4901030751 Issued in MI
Practice address
1750 S Telegraph Rd
Suite 303
Bloomfield Hills, MI 48302-0179
Phone
(248) 334-4906
Fax
(248) 334-2710
NPI assigned
Oct 31, 2005
Last updated
Nov 28, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4901030751 MI Primary

Addresses

Primary practice location

1750 S Telegraph Rd
Suite 303
Bloomfield Hills, MI 48302-0179

Mailing address

1750 S Telegraph Rd
Suite 303
Bloomfield Hills, MI 48302-0179
Phone (248) 334-4906

Other identifiers 1

IdentifierTypeStateIssuer
1081667MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4901030751MIMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1053302851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 S TELEGRAPH RD",
            "address_2": "SUITE 303",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020179",
            "telephone_number": "248-334-4906",
            "fax_number": "248-334-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 S TELEGRAPH RD",
            "address_2": "SUITE 303",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020179",
            "telephone_number": "248-334-4906",
            "fax_number": "248-334-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINDLIN",
        "first_name": "ALAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4901030751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1081667",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.