Individual provider Active NPI

Andrew S Ogawa, MD

  • Ophthalmology Physician
  • Rochester Hills, MI
National Provider Identifier
1396793832
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
AO029327 Issued in MI
Practice address
375 Barclay Cir
Rochester Hills, MI 48307-4511
Phone
(248) 852-3636
Fax
(248) 852-3631
NPI assigned
May 5, 2006
Last updated
Jan 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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 AO029327 MI Primary

Addresses

Primary practice location

375 Barclay Cir
Rochester Hills, MI 48307-4511

Mailing address

375 Barclay Cir
Rochester Hills, MI 48307-4511
Phone (248) 852-3636

Other identifiers 1

IdentifierTypeStateIssuer
AO029327OtherMISTATE LICENSE NUMBER

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
I20080122000587 MI Practitioner - Ophthalmology 4880775303 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AO029327MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millman-Derr Center for Eye Care, P.C. CurrentSince Dec 1, 2012 Accepting new patients
Millman-Derr Center for Eye Care, P.C. Ophthalmology CurrentSince Dec 1, 2012 Accepting new patients

Locations

375 Barclay Cir
Rochester Hills, MI 48307
Phone (248) 491-8894

Organizations & group practices 2

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1396793832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 BARCLAY CIR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483074511",
            "telephone_number": "248-852-3636",
            "fax_number": "248-852-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 BARCLAY CIR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483074511",
            "telephone_number": "248-852-3636",
            "fax_number": "248-852-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGAWA",
        "first_name": "ANDREW",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "AO029327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "AO029327",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.