Organization Active NPI

Synapse Neurodiagnostics

  • Electroneurodiagnostic Specialist/Technologist
  • W Bloomfield, MI
National Provider Identifier
1407175102
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
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

Updated by the provider on Sep 19, 2024

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)CodeLicenseStatePrimary
Other Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246Z00000X
EEG Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246ZE0500X
Electroneurodiagnostic Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246ZE0600X Primary
Other TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 247200000X
EEG TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
O20120410000088 MI Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0840451316 Practice locations: West Bloomfield, MI

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.