Active NPI
Michael J Lipson, OD
- Optometrist
- Walled Lake, MI
National Provider Identifier
1255485116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901002621
- Practice address
- 4257 Ascott LN
Walled Lake, MI 48390-1366 - Phone
- (248) 420-0585
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 4901002621 | MI | Primary |
Addresses
Primary practice location
4257 Ascott LN
Walled Lake, MI 48390-1366
Mailing address
4257 Ascott LN
Commerce TWP, MI 48390-1366
Phone (248) 420-0585
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4404879 | Medicaid | MI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605139200000",
"number": "1255485116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4257 ASCOTT LN",
"city": "COMMERCE TWP",
"state": "MI",
"postal_code": "483901366",
"telephone_number": "248-420-0585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4257 ASCOTT LN",
"city": "WALLED LAKE",
"state": "MI",
"postal_code": "483901366",
"telephone_number": "248-420-0585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPSON",
"first_name": "MICHAEL",
"middle_name": "J",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2020-11-12",
"certification_date": "2020-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901002621",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4404879",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Walled Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.