Individual provider Active NPI

Yocheved Kresch

  • Optometrist
  • Oak Park, MI
National Provider Identifier
1396123469
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005359 Issued in MI
Practice address
25211 Coolidge Hwy
Oak Park, MI 48237-3165
Phone
(248) 545-2800
Fax
(248) 581-4074
NPI assigned
May 11, 2015
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005359 MI Primary
Corneal and Contact Management Optometrist 152WC0802X 4901005359 MI
Pediatric Optometrist 152WP0200X 4901005359 MI

Addresses

Primary practice location

25211 Coolidge Hwy
Oak Park, MI 48237-3165

Mailing address

25211 Coolidge Hwy
Oak Park, MI 48237-3165
Phone (248) 545-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MI2 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
I20161103001532 NY Practitioner - Optometry 0446538904 Reassigns benefits to 2 organizations
I20210929001164 MI Practitioner - Optometry 0446538904 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005359MIMDPediatric Optometrist
008273NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Ophthalmology CurrentSince Sep 14, 2021 Accepting new patients
Harvey Rosenblum, MD,PC Optometrist CurrentSince Sep 14, 2016 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Apr 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York Ophthalmology Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Apr 1, 2018 Accepting new patients
Wise Eyes LLC Optometrist CurrentSince Mar 19, 2025 Accepting new patients

Locations

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

25211 Coolidge Hwy
Oak Park, MI 48237
Phone (248) 544-0560

26400 W 12 Mile Rd
Ste 60
Southfield, MI 48034
Phone (248) 594-6702

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

220 Madison Ave
New York, NY 10016
Phone (212) 683-7330

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

635 W 165th St
New York, NY 10032
Phone (212) 305-3039

880 3rd Ave
New York, NY 10022
Phone (212) 342-3746

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

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": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1396123469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25211 COOLIDGE HWY",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373165",
            "telephone_number": "248-545-2800",
            "fax_number": "248-581-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25211 COOLIDGE HWY",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373165",
            "telephone_number": "248-545-2800",
            "fax_number": "248-581-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRESCH",
        "first_name": "YOCHEVED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005359",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MI",
            "license": "4901005359",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MI",
            "license": "4901005359",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

Verify at the official NPI Registry.