Individual provider Active NPI

Marshall N Cyrlin, MD

  • Ophthalmology Physician
  • Bingham Farms, MI
National Provider Identifier
1609867043
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301045954 Issued in MI
Practice address
31500 Telegraph Rd
Ste 005
Bingham Farms, MI 48025-4367
Phone
(248) 594-6702
Fax
(248) 594-6738
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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 4301045954 MI Primary

Addresses

Primary practice location

31500 Telegraph Rd
Ste 005
Bingham Farms, MI 48025-4367

Mailing address

1560 E Maple Rd
Suite 400-Credentialing
Troy, MI 48083
Phone (248) 594-6702

Other identifiers 1

IdentifierTypeStateIssuer
1439861MedicaidMI

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
I20050613001200 MI Practitioner - Ophthalmology 2466495700 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301045954MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Ophthalmology CurrentSince Jan 1, 2015 Accepting new patients

Locations

31500 Telegraph Rd
Ste 005
Bingham Farms, MI 48025
Phone (248) 594-6702

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

1560 E Maple Rd
Ste 400
Troy, MI 48083

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1609867043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48083",
            "telephone_number": "248-594-6702",
            "fax_number": "248-594-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31500 TELEGRAPH RD",
            "address_2": "STE 005",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254367",
            "telephone_number": "248-594-6702",
            "fax_number": "248-594-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYRLIN",
        "first_name": "MARSHALL",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301045954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1439861",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

Verify at the official NPI Registry.