Individual provider Active NPI

Mark Herman Haimann, MD

  • Ophthalmology Physician
  • Southfield, MI
National Provider Identifier
1376571042
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
43010 45785 Issued in MI
Practice address
29201 Telegraph Rd
Suite 606
Southfield, MI 48034-1331
Phone
(248) 356-8610
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 43010 45785 MI Primary

Addresses

Primary practice location

29201 Telegraph Rd
Suite 606
Southfield, MI 48034-1331

Mailing address

29201 Telegraph Rd
Suite 606
Southfield, MI 48034-1331
Phone (248) 356-8610

Other identifiers 1

IdentifierTypeStateIssuer
1532688MedicaidMI

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
I20160302000140 MI Order and Referring Only - OphthalmologyPractitioner - Ophthalmology 8628141959

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43010 45785MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harold Weiss MD&Mark Haimann MD&Joel Miller MD&Susan Malinowski MD Ophthalmology PastSince Jan 1, 2007 Accepting new patients

Organizations & group practices 1

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376571042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29201 TELEGRAPH RD",
            "address_2": "SUITE 606",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341331",
            "telephone_number": "248-356-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29201 TELEGRAPH RD",
            "address_2": "SUITE 606",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341331",
            "telephone_number": "248-356-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIMANN",
        "first_name": "MARK",
        "middle_name": "HERMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "43010 45785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1532688",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.