Individual provider Active NPI

Ralph J Gentile, OD

  • Optometrist
  • Waterford, MI
National Provider Identifier
1306982517
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003012 Issued in MI
Practice address
7180 Highland Rd
Waterford, MI 48327
Phone
(248) 666-4020
Fax
(248) 666-4173
NPI assigned
Jan 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003012 MI Primary

Addresses

Primary practice location

7180 Highland Rd
Waterford, MI 48327

Mailing address

140 Macomb
Mt Clemens, MI 48043
Phone (586) 468-7370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090505000078 MI Practitioner - Optometry 5294883054 Reassigns benefits to 1 organization
I20210820001048 OH Practitioner - Optometry 5294883054 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SVS Vision Inc Optometrist Current Accepting new patients
SVS Vision Inc Optometrist CurrentSince Mar 23, 2009 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Mar 23, 2009 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Aug 13, 2021 Accepting new patients
SVS Vision Inc Optometrist Current Accepting new patients

Locations

3192 S Linden Rd
Ste B121
Flint, MI 48507
Phone (810) 230-9300

118 Cass Ave
Mount Clemens, MI 48043
Phone (586) 464-1479

140 Macomb Pl
Mount Clemens, MI 48043
Phone (586) 464-1479

7084 Highland Rd
Waterford, MI 48327
Phone (248) 666-4020

7180 Highland Rd
Waterford, MI 48327
Phone (248) 666-4020

7710 Montgomery Rd
Ste A
Cincinnati, OH 45236

7710A Montgomery Rd
Cincinnati, OH 45236
Phone (513) 791-5911

2870 W Market St
Ste B
Fairlawn, OH 44333
Phone (234) 303-2560

2720 Elida Rd
Ste 124
Lima, OH 45805
Phone (419) 225-7100

7689 Mentor Ave
Mentor, OH 44060
Phone (440) 742-4900

4315 Milan Rd
Sandusky, OH 44870
Phone (419) 624-0456

4038 Talmadge Rd
Ste 107
Toledo, OH 43623
Phone (419) 476-7321

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306982517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MACOMB",
            "city": "MT CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "586-468-7370",
            "fax_number": "586-464-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7180 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "48327",
            "telephone_number": "248-666-4020",
            "fax_number": "248-666-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "RALPH",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.