NPIMap

Organization Active NPI

Cataract Specialty Surgical Center, LLC

Doing business as Cataract specialty surgical center

  • Ambulatory Surgical Clinic/Center
  • Berkley, MI
National Provider Identifier
1528061918
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
636901 Issued in MI
Legal business name
CATARACT SPECIALTY SURGICAL CENTER, LLC
Doing business as
Cataract specialty surgical center
Practice address
28747 Woodward Ave Lowr Level
Berkley, MI 48072-0931
Phone
(248) 584-4602
Fax
(248) 584-4630
NPI assigned
May 31, 2005
Last updated
May 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Authorized official

Name
Deborah Jankowski, BSN, RN
Title
Administator
Phone
(248) 586-4602

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 636901 MI Primary
Ophthalmology Physician 207W00000X

Addresses

Primary practice location

28747 Woodward Ave Lowr Level
Berkley, MI 48072-0931

Mailing address

28747 Woodward Ave
Lower Level
Berkley, MI 48072-0914
Phone (248) 584-4602

Other identifiers 1

IdentifierTypeStateIssuer
P00089786OtherRR MEDICARE

Other names 1

  • Cataract specialty surgical center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804001425 MI Part B Supplier - Ambulatory Surgical Center 6103897905 Practice locations: Berkley, MI

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Cataract Specialty Surgical CenterCCN 23C0001038
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2218 Reliable Pkwy
Chicago, IL 60686

28747 Woodward Ave
Lowr
Berkley, MI 48072
Phone (248) 584-4602

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1528061918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28747 WOODWARD AVE",
            "address_2": "LOWER LEVEL",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480720914",
            "telephone_number": "248-584-4602",
            "fax_number": "248-584-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28747 WOODWARD AVE LOWR LEVEL",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480720931",
            "telephone_number": "248-584-4602",
            "fax_number": "248-584-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATARACT SPECIALTY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "JANKOWSKI",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTATOR",
        "authorized_official_telephone_number": "248-586-4602",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "636901",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00089786",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cataract specialty surgical center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berkley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.