Individual provider Active NPI

Elizabeth Yates, OD

  • Optometrist
  • Detroit, MI
National Provider Identifier
1457492407
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003931 Issued in MI
Practice address
4717 Saint Antoine St
Kresge Eye Institute
Detroit, MI 48201-1423
Phone
(313) 577-8900
Fax
(313) 577-0700
NPI assigned
Feb 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003931 MI Primary

Addresses

Primary practice location

4717 Saint Antoine St
Kresge Eye Institute
Detroit, MI 48201-1423

Mailing address

1420 Stephenson Hwy
Suite 400 - Credentialing
Troy, MI 48083-1189
Phone (248) 581-5977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pearle Vision Inc Optometrist Past Accepting new patients
Northwest Eye Foundation Past Accepting new patients
Pearle Vision Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1457492407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 STEPHENSON HWY",
            "address_2": "SUITE 400 - CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831189",
            "telephone_number": "248-581-5977",
            "fax_number": "248-581-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4717 SAINT ANTOINE ST",
            "address_2": "KRESGE EYE INSTITUTE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011423",
            "telephone_number": "313-577-8900",
            "fax_number": "313-577-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-11",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.