Organization Active NPI

David H Susewitz

  • Optician
  • Trenton, MI
National Provider Identifier
1053594572
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
DAVID H SUSEWITZ
Practice address
2644 W Jefferson Ave
Trenton, MI 48183-2803
Phone
(734) 675-4060
NPI assigned
Dec 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Authorized official

Name
David SusewitzNPI 1417008350
Title
Owner/Optician
Phone
(734) 675-4060

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
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

2644 W Jefferson Ave
Trenton, MI 48183-2803

Mailing address

2644 W Jefferson Ave
Trenton, MI 48183-2803
Phone (734) 675-4060

Other identifiers 1

IdentifierTypeStateIssuer
900H21185OtherMIBLUE CROSS

Other names 1

  • Optical Ideas Doing business as

National Provider Directory

National Provider Directory

Locations

2644 W Jefferson Ave
Trenton, MI 48183
Phone (734) 675-4060

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": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1053594572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2644 W JEFFERSON AVE",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832803",
            "telephone_number": "734-675-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2644 W JEFFERSON AVE",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832803",
            "telephone_number": "734-675-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID H SUSEWITZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "SUSEWITZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/OPTICIAN",
        "authorized_official_telephone_number": "734-675-4060"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "900H21185",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optical Ideas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.