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

Last updated

Jan 22, 2020By the provider in NPPES

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

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

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cataract and Eye Consultants of Mi PC

  dba Optical Associates

  • 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": [],
    "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 (sul)
• 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.