Active NPI
Kathryn Anne Baruch, O.D.
- Optometrist
- Royal Oak, MI
National Provider Identifier
1215197587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901004546
- Practice address
- 621 W 11 Mile Rd
Royal Oak, MI 48067-2201 - Phone
- (248) 541-4200
- NPI assigned
- Jun 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901004546 | MI | Primary |
Addresses
Primary practice location
621 W 11 Mile Rd
Royal Oak, MI 48067-2201
Mailing address
621 W 11 Mile Rd
Royal Oak, MI 48067-2201
Phone (248) 541-4200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4901004546 | MI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276560000000",
"number": "1215197587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 W 11 MILE RD",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480672201",
"telephone_number": "248-541-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 W 11 MILE RD",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480672201",
"telephone_number": "248-541-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARUCH",
"first_name": "KATHRYN",
"middle_name": "ANNE",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-11",
"last_updated": "2010-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901004546",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.