Organization Active NPI

Paul R Gayeff OD PC

  • Optometrist
  • Escanaba, MI
National Provider Identifier
1285767509
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002306 Issued in MI
Legal business name
PAUL R GAYEFF OD PC
Practice address
2500 7TH Ave S
Suite 217
Escanaba, MI 49829-1176
Phone
(906) 789-1400
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Authorized official

Name
Paul R Gayeff, O.D.
Title
Optometrist
Phone
(906) 786-2664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4901002306 MI Primary

Addresses

Primary practice location

2500 7TH Ave S
Suite 217
Escanaba, MI 49829-1176

Mailing address

2500 7TH Ave S
Suite 217
Escanaba, MI 49829-1176
Phone (906) 789-1400

Other identifiers 3

IdentifierTypeStateIssuer
5096229MedicaidMI
DG1305OtherRAILROAD MEDICARE
900B110170OtherMIBCBS OF MI

National Provider Directory

National Provider Directory

Locations

2500 7th Ave S
Ste 217
Escanaba, MI 49829
Phone (906) 789-1400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1285767509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 7TH AVE S",
            "address_2": "SUITE 217",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291176",
            "telephone_number": "906-789-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 7TH AVE S",
            "address_2": "SUITE 217",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291176",
            "telephone_number": "906-789-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL R GAYEFF OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "GAYEFF",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "906-786-2664",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5096229",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG1305",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "900B110170",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.