Organization Active NPI

Andersen Eye Associates, PLC

  • Eyewear Supplier
  • Saginaw, MI
National Provider Identifier
1124106489
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
ANDERSEN EYE ASSOCIATES, PLC
Practice address
5161 Cardinal Park Drive
Saginaw, MI 48604-9435
Phone
(989) 249-8853
Fax
(989) 249-8842
NPI assigned
Nov 2, 2006
Last updated
Apr 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Authorized official

Name
Sue Gardner
Title
Billing Manager
Phone
(989) 249-8853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary

Addresses

Primary practice location

5161 Cardinal Park Drive
Saginaw, MI 48604-9435

Mailing address

PO Box 5649
Saginaw, MI 48603-0649
Phone (989) 249-8853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040526001033 MI Part B Supplier - Clinic/Group Practice 8921089871 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay City, MI; Birch Run, MI; Frankenmuth, MI; Saginaw, MI
O20051021000642 MI Part B Supplier - Clinic/Group Practice 8921089871 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay City, MI; Saginaw, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

408 N State St
Alma, MI 48801
Phone (517) 463-1139

504 N Franklin St
Frankenmuth, MI 48734
Phone (989) 652-2626

5400 Mackinaw Rd
Ste 5000
Saginaw, MI 48604
Phone (517) 797-2400

70 N Frost Dr
Ste 3
Saginaw, MI 48638
Phone (517) 799-1533

295 N Main St
Vassar, MI 48768
Phone (517) 823-8559

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302652800000",
    "number": "1124106489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5649",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486030649",
            "telephone_number": "989-249-8853",
            "fax_number": "989-249-8842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5161 CARDINAL PARK DRIVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486049435",
            "telephone_number": "989-249-8853",
            "fax_number": "989-249-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSEN EYE ASSOCIATES, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2011-04-13",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "989-249-8853"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.