NPIMap

Organization Active NPI

Shoreline Ophthalmology, PLLC

  • Ophthalmology Physician
  • Fremont, MI
National Provider Identifier
1588859797
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SHORELINE OPHTHALMOLOGY, PLLC
Practice address
1401 W Main St
Suite 101
Fremont, MI 49412-1486
Phone
(231) 924-9009
Fax
(231) 924-4604
NPI assigned
Sep 11, 2007
Last updated
May 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Authorized official

Name
Dr. Joseph Gira
Title
Owner
Phone
(231) 739-9009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1401 W Main St
Suite 101
Fremont, MI 49412-1486

Mailing address

1266 E Sherman Blvd
Muskegon, MI 49444-1847
Phone (231) 739-9009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041118000693 MI Part B Supplier - Clinic/Group Practice 3678537628 Receives reassigned benefits from 10 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spring Lake, MI; North Muskegon, MI; Muskegon, MI; Grand Haven, MI; Fremont, MI
O20060613000017 MI Part B Supplier - Clinic/Group Practice 3678537628 Receives reassigned benefits from 7 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fremont, MI; Grand Haven, MI; Muskegon, MI; North Muskegon, MI

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Shoreline Ophthalmology PLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1588859797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1266 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441847",
            "telephone_number": "231-739-9009",
            "fax_number": "231-733-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W MAIN ST",
            "address_2": "SUITE 101",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121486",
            "telephone_number": "231-924-9009",
            "fax_number": "231-924-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE OPHTHALMOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "GIRA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-739-9009",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.