Mark D. Engelman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

490122485 Issued in MI

Practice address

3385 S Center Rd
Burton, MI 48519-1457

Phone

(810) 244-3434

Fax

(810) 715-0301

NPI assigned

Jan 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1093795452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3385 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191457",
            "telephone_number": "810-244-3434",
            "fax_number": "810-715-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191457",
            "telephone_number": "810-244-3434",
            "fax_number": "810-715-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELMAN",
        "first_name": "MARK",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "490122485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCSUPPLY",
            "identifier": "0950190001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCVISION",
            "identifier": "ME002485",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elite Provider Group PC
• Elite Provider Group PC
• Aniya Domynique Ellison
• Abusufian Eltaib Eltahir, B-PHARM
• Engelman Vision Associates PLLC
• Michael John Engelman, OD
• Skilar Rae Engman
• Jennifer E. Ervin, ACNP-BC, MSN, RN
• Amanda Nicole Escalera-Torres, RDN
• Sara Esch, WHNP

• Optometrist in Burton, MI
• Providers in Burton, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.