NPIMap

Organization Active NPI

Regents of the University of Michigan

  • Optometrist
  • Ann Arbor, MI
National Provider Identifier
1255356903
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
REGENTS OF THE UNIVERSITY OF MICHIGAN
Practice address
1000 Wall St
Ann Arbor, MI 48105
Phone
(734) 763-1415
NPI assigned
Jul 13, 2006
Last updated
May 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Authorized official

Name
David Christopher MillerNPI 1629092713
Title
President
Phone
(734) 936-3568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Corneal and Contact Management Optometrist 152WC0802X NU
Low Vision Rehabilitation Optometrist 152WL0500X NU
Pediatric Optometrist 152WP0200X NU
Sports Vision Optometrist 152WS0006X NU
Vision Therapy Optometrist 152WV0400X NU
Occupational Vision Optometrist 152WX0102X NU

Addresses

Primary practice location

1000 Wall St
Ann Arbor, MI 48105

Mailing address

3621 S State St
Provider Enrollment
Ann Arbor, MI 48108
Phone (734) 647-5299

Other identifiers 1

IdentifierTypeStateIssuer
900Q17650OtherMIBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000292 MI Part B Supplier - Clinic/Group Practice 3779496856 Receives reassigned benefits from 16 practitioners
1 other NPI on this enrollment
Practice locations: Ann Arbor, MI; Brighton, MI; Canton, MI; Grand Blanc, MI; Northville, MI; Ypsilanti, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Chelsea Internal Medici157 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All facility ownership & control disclosures 17

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
University of Michigan Health-Sparrow EatonCharlotte, MI, CCN 231327 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health - WestWyoming, MI, CCN 230236 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 15, 2016
University of Michigan Health-Sparrow LansingLansing, MI, CCN 230230 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow IoniaIonia, MI, CCN 231331 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-SparrowLansing, MI, CCN 23T230 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2024
University of Michigan Health-SparrowCarson City, MI, CCN 230208 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
Chelsea HospitalChelsea, MI, CCN 230259 Hospital 5% Or Greater Direct Ownership Interest (49%) Jul 1, 2018
Chelsea HospitalChelsea, MI, CCN 23T259 Hospital 5% Or Greater Direct Ownership Interest (49%) Jul 1, 2018
University of Michigan Health-SparrowSaint Johns, MI, CCN 23Z326 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow CarsonCarson City, MI, CCN 23U208 Hospital 5% Or Greater Indirect Ownership Interest (100%) Mar 1, 2025
University of Michigan Health-SparrowLansing, MI, CCN 231519 Hospice 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow IoniaIonia, MI, CCN 238550 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-SparrowGreenville, MI, CCN 233996 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow Ithaca Primary CareIthaca, MI, CCN 238517 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-SparrowStanton, MI, CCN 238574 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow Portland Primary CarePortland, MI, CCN 238631 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023
University of Michigan Health-Sparrow Saranac Primary CareSaranac, MI, CCN 238698 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2023

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1255356903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALL ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-763-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-05-03",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-936-3568"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900Q17650",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.