Organization Active NPI

Advanced Mobile Eye Care, LLC

  • Optometrist
  • Saint Joseph, MI
National Provider Identifier
1487832556
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003732 Issued in MI
Legal business name
ADVANCED MOBILE EYE CARE, LLC
Practice address
2810 Niles Rd
Saint Joseph, MI 49085-3357
Phone
(269) 429-6781
Fax
(269) 429-5006
NPI assigned
Jan 31, 2008
Last updated
Aug 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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

Authorized official

Name
Dr. Jeffrey Fred Scieszka, O.D.NPI 1316160252
Title
Owner
Phone
(269) 369-6752

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003732 MI Primary

Addresses

Primary practice location

2810 Niles Rd
Saint Joseph, MI 49085-3357

Mailing address

2810 Niles Rd
Saint Joseph, MI 49085-3357
Phone (269) 429-6781

Other identifiers 1

IdentifierTypeStateIssuer
OP55030OtherMIMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

2810 Niles Rd
Saint Joseph, MI 49085
Phone (269) 429-6781

Practitioners & affiliated clinicians

Practitioners 5

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": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1487832556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853357",
            "telephone_number": "269-429-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853357",
            "telephone_number": "269-429-6781",
            "fax_number": "269-429-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MOBILE EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "SCIESZKA",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "FRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-369-6752",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "OP55030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.