Individual provider Active NPI

Nicholas David Shokoohi, M.D.

  • Ophthalmology Physician
  • Saginaw, MI
National Provider Identifier
1295180214
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301502033 Issued in MI
Practice address
2393 Schust Rd
Saginaw, MI 48603-1334
Phone
(989) 793-2820
Fax
(989) 755-1463
NPI assigned
Apr 27, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 4301502033 MI Primary

Addresses

Primary practice location

2393 Schust Rd
Saginaw, MI 48603-1334

Mailing address

2393 Schust Rd
Saginaw, MI 48603-1334
Phone (989) 793-2820

Other practice location 1

800 Woodside Ave
Bay City, MI 48708-5468
Phone (989) 892-6616

Other practice location 2

345 N State St
Caro, MI 48723-1537
Phone (989) 872-3800

Other practice location 3

1671 E US 23
East Tawas, MI 48730-9302
Phone (989) 362-4401

Other practice location 4

406 W Genesee St
Frankenmuth, MI 48734-1335
Phone (989) 652-2020

Other practice location 5

623 W Warwick Dr Ste 1
Alma, MI 48801-1177
Phone (989) 506-7668

Other practice location 6

407 W Wackerly St
Midland, MI 48640-2739
Phone (989) 631-1345

Other practice location 7

2393 Schust Rd
Saginaw, MI 48603-1334
Phone (989) 793-2820 ext. 323

Other identifiers 1

IdentifierTypeStateIssuer
4301502033OtherMIPHYSICIAN LICENSE

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200731002917 MI Practitioner - Ophthalmology 5395036800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Wayne State University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Eye InstituteGroup PAC ID 5799699534, 13 clinicians

Practice addresses (Care Compare)

2393 Schust Rd
Saginaw, MI 48603-1334
Phone (989) 793-2820

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as group
Quality
85.25
Improvement activities
40
Cost
75.43

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Eye Institute Multi-Specialty CurrentSince Aug 1, 2020 Accepting new patients
Great Lakes Eye Institute Multi-Specialty CurrentSince Aug 1, 2020 Accepting new patients
Great Lakes Eye Surgery Center LLC Past Accepting new patients

Locations

623 W Warwick Dr
Ste 1
Alma, MI 48801
Phone (989) 285-1490

623 W Warwick Dr
Alma, MI 48801
Phone (989) 285-1490

800 Woodside Ave
Bay City, MI 48708
Phone (989) 892-6616

345 N State St
Caro, MI 48723
Phone (989) 672-5151

4624 Hill St
Cass City, MI 48726
Phone (989) 793-2820

1671 E US 23
East Tawas, MI 48730
Phone (989) 362-4401

406 W Genesee St
Frankenmuth, MI 48734
Phone (517) 652-2020

407 W Wackerly St
Midland, MI 48640
Phone (989) 631-1345

2393 Schust Rd
Saginaw, MI 48603
Phone (989) 793-2820

Interoperability endpoints

  • Direct secure messaging: nds@glei.ecldirect.net

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1295180214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2393 SCHUST RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031334",
            "telephone_number": "989-793-2820",
            "fax_number": "989-755-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2393 SCHUST RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031334",
            "telephone_number": "989-793-2820",
            "fax_number": "989-755-1463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Woodside Ave",
            "address_purpose": "LOCATION",
            "city": "Bay City",
            "state": "MI",
            "postal_code": "487085468",
            "country_code": "US",
            "telephone_number": "989-892-6616",
            "fax_number": "989-755-1463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "345 N State St",
            "address_purpose": "LOCATION",
            "city": "Caro",
            "state": "MI",
            "postal_code": "487231537",
            "country_code": "US",
            "telephone_number": "989-872-3800",
            "fax_number": "989-755-1463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1671 E US 23",
            "address_purpose": "LOCATION",
            "city": "East Tawas",
            "state": "MI",
            "postal_code": "487309302",
            "country_code": "US",
            "telephone_number": "989-362-4401",
            "fax_number": "989-755-1463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "406 W Genesee St",
            "address_purpose": "LOCATION",
            "city": "Frankenmuth",
            "state": "MI",
            "postal_code": "487341335",
            "country_code": "US",
            "telephone_number": "989-652-2020",
            "fax_number": "989-755-1463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "623 W Warwick Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Alma",
            "state": "MI",
            "postal_code": "488011177",
            "country_code": "US",
            "telephone_number": "989-506-7668",
            "fax_number": "989-755-1463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "407 W Wackerly St",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "486402739",
            "country_code": "US",
            "telephone_number": "989-631-1345",
            "fax_number": "989-755-1463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2393 Schust Rd",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486031334",
            "country_code": "US",
            "telephone_number": "989-793-2820 x323",
            "fax_number": "989-755-1463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOKOOHI",
        "first_name": "NICHOLAS",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301502033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "4301502033",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.