Active NPI
Jaime Brooke Zadoff, O.D., FAAO
- Optometrist
- Detroit, MI
National Provider Identifier
1306005764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901004460
- Practice address
- 4646 John R St
Detroit, MI 48201-1916 - Phone
- (313) 576-1000
- NPI assigned
- Jun 2, 2008
- Sex
- Female
- 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 | 4901004460 | MI | Primary |
Addresses
Primary practice location
4646 John R St
Detroit, MI 48201-1916
Mailing address
4646 John R St
Detroit, MI 48201-1916
Phone (313) 576-1000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5330000926 | Other | MI | BOARD OF PHARMACY CONTROLLED SUBSTANCE LICENSE |
| 4901004460 | Other | MI | BOARD OF OPTOMETRY DIAGNOSTIC/THERAPEUTIC PHARMACEUTICAL AGENTS CERT. |
Other names 1
- Dr. Jaime Brooke Cohen
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901004460 | MI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396483200000",
"number": "1306005764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4646 JOHN R ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011916",
"telephone_number": "313-576-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 JOHN R ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011916",
"telephone_number": "313-576-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZADOFF",
"first_name": "JAIME",
"middle_name": "BROOKE",
"name_prefix": "Dr.",
"credential": "O.D., FAAO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-02",
"last_updated": "2014-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901004460",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY CONTROLLED SUBSTANCE LICENSE",
"identifier": "5330000926",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF OPTOMETRY DIAGNOSTIC/THERAPEUTIC PHARMACEUTICAL AGENTS CERT.",
"identifier": "4901004460",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JAIME",
"last_name": "COHEN",
"middle_name": "BROOKE",
"prefix": "DR.",
"credential": "O.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.