Individual provider Active NPI

Amy K Wozniak, O.D.

  • Optometrist
  • Rochester Hills, MI
National Provider Identifier
1205908928
Registry record updated Mar 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003787 Issued in MI
Practice address
137 S Livernois Rd
Rochester Hills, MI 48307-1837
Phone
(248) 652-0600
Fax
(248) 652-2661
NPI assigned
Nov 15, 2006
Sex
Female
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 4901003787 MI Primary

Addresses

Primary practice location

137 S Livernois Rd
Rochester Hills, MI 48307-1837

Mailing address

137 S Livernois Rd
Rochester Hills, MI 48307-1837
Phone (248) 652-0600

Other identifiers 1

IdentifierTypeStateIssuer
4516089MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090727000590 MI Practitioner - Optometry 8729131545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SVS Vision Inc Optometrist Current Accepting new patients
SVS Vision Inc Optometrist CurrentSince Jul 1, 2009 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Jul 1, 2009 Accepting new patients

Locations

50940 Gratiot Ave
Chesterfield, MI 48051
Phone (586) 267-9020

118 Cass Ave
Mount Clemens, MI 48043
Phone (586) 464-1479

5761 E 12 Mile Rd
Warren, MI 48092
Phone (586) 619-3600

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1205908928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 S LIVERNOIS RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483071837",
            "telephone_number": "248-652-0600",
            "fax_number": "248-652-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 S LIVERNOIS RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483071837",
            "telephone_number": "248-652-0600",
            "fax_number": "248-652-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOZNIAK",
        "first_name": "AMY",
        "middle_name": "K",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4516089",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.