Individual provider Active NPI

Paul H Ernest, MD

  • Ophthalmology Physician
  • Jackson, MI
National Provider Identifier
1508861659
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301034151 Issued in MI
Practice address
1116 W Ganson St
Jackson, MI 49202-4240
Phone
(517) 782-9436
Fax
(517) 782-5166
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4301034151 MI Primary

Addresses

Primary practice location

1116 W Ganson St
Jackson, MI 49202-4240

Mailing address

850 W North St Ste 104
Jackson, MI 49202-3196
Phone (517) 841-3022

Other identifiers 7

IdentifierTypeStateIssuer
180F373640OtherMIBCBSM
3037757MedicaidMI
180C846310OtherMIBCBSM
180H149970OtherMIBCBSM
3286304MedicaidMI
180019352OtherRAILROAD MEDICARE
3229602MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100622000934 MI Practitioner - Ophthalmology 3072425529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Wayne State University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid Michigan Eye Care Center PCGroup PAC ID 4486566098, 31 clinicians

Practice addresses (Care Compare)

1116 W Ganson St
Jackson, MI 49202-4240
Phone (517) 782-9436

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301034151MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Michigan Eye Care Center, PC Ophthalmology CurrentSince Apr 1, 1994 Accepting new patients

Locations

580 Riverside Ave
Adrian, MI 49221
Phone (517) 265-6055

2350 E Stadium Blvd
Ste 10
Ann Arbor, MI 48104
Phone (734) 404-7600

2518 Capital Ave SW
Battle Creek, MI 49015

363 Fremont St
Ste 301
Battle Creek, MI 49017
Phone (616) 964-3018

1600 Commerce Park Dr
Ste 100
Chelsea, MI 48118
Phone (734) 475-7359

850 W North St
#104
Jackson, MI 49202
Phone (248) 647-9790

1116 W Ganson St
Jackson, MI 49202
Phone (517) 782-9436

850 W North St
Ste 100
Jackson, MI 49202
Phone (517) 290-5298

2775 Blake Rd
Jackson, MI 49201
Phone (517) 787-2906

4016 W Main St
Kalamazoo, MI 49006
Phone (269) 344-3366

1515 Lake Lansing Rd
Ste H
Lansing, MI 48912
Phone (517) 487-6511

1350 W Centre Ave
Ste 110
Portage, MI 49024
Phone (269) 329-1003

Interoperability endpoints

  • Direct secure messaging: pernest461801@direct.hfhs.org

Organizations & group practices 1

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1508861659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W NORTH ST STE 104",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023196",
            "telephone_number": "517-841-3022",
            "fax_number": "517-817-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 W GANSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492024240",
            "telephone_number": "517-782-9436",
            "fax_number": "517-782-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNEST",
        "first_name": "PAUL",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301034151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "180F373640",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3037757",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "180C846310",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "180H149970",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3286304",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180019352",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3229602",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.