NPIMap

Organization Active NPI

Eastside Eye Physicians, PC

  • Eyewear Supplier
  • Saint Clair Shores, MI
National Provider Identifier
1629106240
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EASTSIDE EYE PHYSICIANS, PC
Practice address
25511 Little Mack Ave
Suite a
Saint Clair Shores, MI 48081-3372
Phone
(586) 774-3388
Fax
(586) 774-3169
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Authorized official

Name
Anne M Nachazel, MDNPI 1629064183
Title
Owner
Phone
(586) 774-2020

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
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

25511 Little Mack Ave
Suite a
Saint Clair Shores, MI 48081-3372

Mailing address

25511 Little Mack Ave
Suite a
Saint Clair Shores, MI 48081-3372
Phone (586) 774-3388

National Provider Directory

National Provider Directory
Tax ID family
Eastside Eye Physicians PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

25511 Little Mack Ave
Ste A
St Clr Shores, MI 48081
Phone (586) 774-2020

Practitioners & affiliated clinicians

Practitioners 11

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": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201219200000",
    "number": "1629106240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25511 LITTLE MACK AVE",
            "address_2": "SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813372",
            "telephone_number": "586-774-3388",
            "fax_number": "586-774-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25511 LITTLE MACK AVE",
            "address_2": "SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813372",
            "telephone_number": "586-774-3388",
            "fax_number": "586-774-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE EYE PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2008-01-25",
        "status": "A",
        "authorized_official_last_name": "NACHAZEL",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-774-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.