Richard L Watnick, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4301405297 Issued in MI

Practice address

25350 Kelly Rd
Roseville, MI 48066-5824

Phone

(586) 772-1990

Fax

(586) 772-1137

NPI assigned

Nov 3, 2005

Last updated

Oct 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Clair Shores Mi Ophthalmology ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Saint Clair Shores, MI
  • NPI 1326215468
  NPD (past)

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1144211699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25350 KELLY RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664904",
            "telephone_number": "586-772-1990",
            "fax_number": "586-772-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25350 KELLY RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480665824",
            "telephone_number": "586-772-1990",
            "fax_number": "586-772-1137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 W 13 Mile Rd Ste 555",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736770",
            "country_code": "US",
            "telephone_number": "248-551-2020",
            "fax_number": "248-551-2267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATNICK",
        "first_name": "RICHARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301405297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jala D Walker
• Sadiqua Attillya Warren
• Shamara Watkins
• Tiara Bell Watkins
• Damon Anthony John Watlington Jr.
• Wdwrosevillepllc (Whole Dental Wellness)
• We DO for Family LLC
• We Help Home Care LLC
• David S. Wendel, D.C.
• Bryan C West, D.P.M.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.