Organization Active NPI

Capstone Vision, PLLC

  • Ophthalmology Physician
  • Auburn Hills, MI
National Provider Identifier
1184252165
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CAPSTONE VISION, PLLC
Practice address
691 N Squirrel Rd Ste 202
Auburn Hills, MI 48326-2871
Phone
(248) 710-0063
Fax
(240) 710-0056
NPI assigned
Mar 27, 2020
Last updated
Mar 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Leslie Emmert-Buck, MD, PHDNPI 1467460014
Title
Ceo
Phone
(248) 710-0063

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary
Medical Specialty Clinic/Center 261QM2500X NU

Addresses

Primary practice location

691 N Squirrel Rd Ste 202
Auburn Hills, MI 48326-2871

Mailing address

691 N Squirrel Rd Ste 202
Auburn Hills, MI 48326-2871
Phone (248) 710-0063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200417000202 MI Part B Supplier - Clinic/Group Practice 3173953015 Receives reassigned benefits from 1 practitioner
Practice locations: Auburn Hills, MI

National Provider Directory

National Provider Directory

Locations

3100 Cross Creek Pkwy
Ste 130
Auburn Hills, MI 48326
Phone (248) 710-0063

691 N Squirrel Rd
Ste 202
Auburn Hills, MI 48326
Phone (248) 710-0063

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1184252165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 N SQUIRREL RD STE 202",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262871",
            "telephone_number": "248-710-0063",
            "fax_number": "248-710-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 N SQUIRREL RD STE 202",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262871",
            "telephone_number": "248-710-0063",
            "fax_number": "240-710-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPSTONE VISION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-27",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "EMMERT-BUCK",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-710-0063",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.