Individual provider Active NPI

Arnold Bulos, O.D.

  • Optometrist
  • Ann Arbor, MI
National Provider Identifier
1164590303
Registry record updated Mar 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003799 Issued in MI
Practice address
856 Briarwood Cir
Briarwood Mall
Ann Arbor, MI 48108-1616
Phone
(734) 761-8300
Fax
(734) 769-1018
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003799 MI Primary

Addresses

Primary practice location

856 Briarwood Cir
Briarwood Mall
Ann Arbor, MI 48108-1616

Mailing address

3916 Steamboat CT
Ann Arbor, MI 48108-9324
Phone (734) 769-5777

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

State licenses

LicenseStateTypeSpecialty
4901003799MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pearle Vision Inc Past Accepting new patients
Pearle Vision Inc Past Accepting new patients
The Eye Gallery Optometrist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: arnoldbulosod@the-eye-gallery.direct.kno2fy.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1164590303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 STEAMBOAT CT",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481089324",
            "telephone_number": "734-769-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 BRIARWOOD CIR",
            "address_2": "BRIARWOOD MALL",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081616",
            "telephone_number": "734-761-8300",
            "fax_number": "734-769-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULOS",
        "first_name": "ARNOLD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; 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.