NPIMap

Organization Active NPI

Jartll Corp

Doing business as Roland Optics

  • Optometrist
  • Bloomfield Hills, MI
National Provider Identifier
1417008624
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JARTLL CORP
Doing business as
Roland Optics
Practice address
6523 Telegraph Rd
Bloomfield Hills, MI 48301-3066
Phone
(248) 593-9955
Fax
(248) 593-9966
NPI assigned
Jan 15, 2007
Last updated
Feb 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Authorized official

Name
Heather M Kingery
Title
Insurance Supervisor
Phone
(248) 871-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

6523 Telegraph Rd
Bloomfield Hills, MI 48301-3066

Mailing address

6523 Telegraph Rd
Bloomfield Hills, MI 48301-3066
Phone (248) 593-9955

Other names 1

  • ROLAND OPTICS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070503000237 MI Part B Supplier - Clinic/Group Practice 3274639596 Receives reassigned benefits from 8 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Auburn Hills, MI; Bloomfield Hills, MI; Detroit, MI; Rochester, MI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

4151 Baldwin Rd
Auburn Hills, MI 48326
Phone (248) 858-2223

294 E Walton Blvd
Pontiac, MI 48340
Phone (248) 858-2223

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1417008624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6523 TELEGRAPH RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483013066",
            "telephone_number": "248-593-9955",
            "fax_number": "248-593-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6523 TELEGRAPH RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483013066",
            "telephone_number": "248-593-9955",
            "fax_number": "248-593-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JARTLL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "KINGERY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INSURANCE SUPERVISOR",
        "authorized_official_telephone_number": "248-871-1234"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROLAND OPTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.