Marilynn Sultana-Gallick, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4301047297 Issued in MI

Practice address

29753 Hoover Rd
Ste a
Warren, MI 48093-8900

Phone

(586) 573-4333

Fax

(586) 573-2149

NPI assigned

May 31, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cataract and Eye Consultants of Mi PC

  • Ophthalmology Physician
  • Warren, MI
  • NPI 1194798546
  Medicare reassignment NPD

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1366445769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29753 HOOVER RD",
            "address_2": "STE A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480938900",
            "telephone_number": "586-573-4333",
            "fax_number": "586-573-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29753 HOOVER RD",
            "address_2": "STE A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480938900",
            "telephone_number": "586-573-4333",
            "fax_number": "586-573-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTANA-GALLICK",
        "first_name": "MARILYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301047297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3336110",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MICHIGAN",
            "identifier": "1805005281",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33361100",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Elena Sulich-Moore, DNP, FNP-C
• Deanna Sullivan
• Elizabeth Ann Sullivan, OTRL
• Thomas S. Sullivan, M.S., R.PH., BCNSP
• Sultan Home Care LLC
• Kyle Alexander Suminski, PT
• Summit Oral & Maxillofacial Surgery PC
• Irene Judith Sun, FNP, CRNA
• Sunny Medical Equipment Inc
• Sunrise Dental Center

• Ophthalmology Physician in Warren, MI
• Providers in Warren, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.

Verify at the official NPI Registry.