Individual provider Active NPI

Vanitha Isaac Jeyaraj, MD

  • Ophthalmology Physician
  • Milford, MI
National Provider Identifier
1649409400
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301104104 Issued in MI
Practice address
320 West Commerce Rd
Milford, MI 48381-1892
Phone
(248) 684-7337
Fax
(248) 684-1286
NPI assigned
Jul 14, 2009
Last updated
Jul 31, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125-056436 IL
Ophthalmology Physician 207W00000X 4301104104 MI Primary

Addresses

Primary practice location

320 West Commerce Rd
Milford, MI 48381-1892

Mailing address

3621 South State Street
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Other names 1

  • Vanitha Isaac Johnson Former name

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
I20131118000326 MI Practitioner - Ophthalmology 8820224009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Chicago, Pritzker School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Wall St
Ann Arbor, MI 48105-1912
Phone (734) 764-4190

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 764-4190

39901 Traditions Dr
Northville, MI 48168-9493
Phone (734) 764-4190

7500 Challis Rd
Brighton, MI 48116-9416
Phone (734) 764-4190

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-056436ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Ophthalmology CurrentSince Sep 10, 2013 Accepting new patients
Regents of the University of Michigan CurrentSince Sep 10, 2013 Accepting new patients
Regents of the University of Michigan Past Accepting new patients
Regents of the University of Michigan Ophthalmology Past Accepting new patients

Locations

1000 Wall St
Ann Arbor, MI 48105
Phone (734) 763-1415

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
#700
Ann Arbor, MI 48108

Interoperability endpoints

  • Direct secure messaging: vjeyaraj402437@direct.med.umich.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1649409400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 SOUTH STATE STREET",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WEST COMMERCE RD",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483811892",
            "telephone_number": "248-684-7337",
            "fax_number": "248-684-1286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEYARAJ",
        "first_name": "VANITHA",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125-056436",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301104104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANITHA",
            "last_name": "JOHNSON",
            "middle_name": "ISAAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milford, MI

Sources for this page

Verify at the official NPI Registry.