Active NPI
Synapse Neurodiagnostics
- Electroneurodiagnostic Specialist/Technologist
- W Bloomfield, MI
National Provider Identifier
1407175102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Electroneurodiagnostic Specialist/Technologist
- Legal business name
- SYNAPSE NEURODIAGNOSTICS
- Practice address
- 6418 Mission CT
W Bloomfield, MI 48324-1398 - Phone
- (248) 330-3520
- Fax
- (248) 856-1770
- NPI assigned
- May 20, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gregory Lukasik
- Title
- Administrative Director
- Phone
- (248) 330-3520
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | |||
| EEG Specialist/Technologist | 246ZE0500X | |||
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X | Primary | ||
| Other Technician | 247200000X | |||
| EEG Technician | 2472E0500X | |||
| Sleep Disorder Diagnostic Clinic/Center | 261QS1200X |
Addresses
Primary practice location
6418 Mission CT
W Bloomfield, MI 48324-1398
Mailing address
6418 Mission CT
W Bloomfield, MI 48324-1398
Phone (248) 330-3520
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120410000088 | MI | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 0840451316 | Practice locations: West Bloomfield, MI |
National Provider Directory
National Provider DirectoryLocations
2055 Franklin Rd
Ste 300
Bloomfield Township, MI 48302
Phone (248) 481-8603
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Neurology Physician
- Farmington Hills, MI
- NPI 1356349062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274313600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1726704000000",
"number": "1407175102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6418 MISSION CT",
"city": "W BLOOMFIELD",
"state": "MI",
"postal_code": "483241398",
"telephone_number": "248-330-3520",
"fax_number": "488-561-7702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6418 MISSION CT",
"city": "W BLOOMFIELD",
"state": "MI",
"postal_code": "483241398",
"telephone_number": "248-330-3520",
"fax_number": "248-856-1770"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SYNAPSE NEURODIAGNOSTICS",
"organizational_subpart": "NO",
"enumeration_date": "2010-05-20",
"last_updated": "2024-09-19",
"certification_date": "2024-09-19",
"status": "A",
"authorized_official_last_name": "LUKASIK",
"authorized_official_first_name": "GREGORY",
"authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
"authorized_official_telephone_number": "248-330-3520"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other",
"state": null,
"license": null,
"primary": false
},
{
"code": "246ZE0500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other, EEG",
"state": null,
"license": null,
"primary": false
},
{
"code": "246ZE0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": null,
"license": null,
"primary": true
},
{
"code": "247200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": false
},
{
"code": "2472E0500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Technician, Other, EEG",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QS1200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Sleep Disorder Diagnostic",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in W Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.