NPIMap

Organization Active NPI

Michigan Ophthalmology Specialists, PLLC

  • Ophthalmology Physician
  • Northville, MI
National Provider Identifier
1699486191
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MICHIGAN OPHTHALMOLOGY SPECIALISTS, PLLC
Practice address
40053 8 Mile Rd Ste 100
Northville, MI 48167-1954
Phone
(248) 449-9292
Fax
(248) 449-1081
NPI assigned
Dec 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Authorized official

Name
Beverly Zwicker
Title
Credentialing Manager
Phone
(313) 530-5494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

40053 8 Mile Rd Ste 100
Northville, MI 48167-1954

Mailing address

30150 Telegraph Rd Ste 271
Bingham Farms, MI 48025-4521
Phone (248) 395-5175

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240520001156 MI DME Supplier - Physician - Optometrist 3577557131 Practice locations: Northville, MI

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Michigan Ophthalmology Specialists40053 8 Mile Rd, Northville, MI 48167-2002(248) 449-9292 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Feb 16, 2000

National Provider Directory

National Provider Directory
Tax ID family
Michigan Ophthalmology Specialists PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

31815 Southfield Rd
Ste 12
Beverly Hills, MI 48025
Phone (248) 645-2220

330 E 14 Mile Rd
Ste B
Clawson, MI 48017
Phone (248) 589-9500

24800 Michigan Ave
Dearborn, MI 48124
Phone (313) 561-7255

19855 Outer Dr
Ste G12
Dearborn, MI 48124
Phone (313) 561-7255

32255 Northwestern Hwy
Ste 130A
Farmington Hills, MI 48334
Phone (248) 723-5880

301 W 13 Mile Rd
Madison Heights, MI 48071
Phone (248) 268-1079

47670 Van Dyke Ave
Shelby Township, MI 48317
Phone (586) 250-2972

29201 Telegraph Rd
Ste 101
Southfield, MI 48034
Phone (248) 350-1130

2125 Butterfield Dr
Ste 201N
Troy, MI 48084
Phone (248) 649-1644

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1699486191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30150 TELEGRAPH RD STE 271",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254521",
            "telephone_number": "248-395-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40053 8 MILE RD STE 100",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671954",
            "telephone_number": "248-449-9292",
            "fax_number": "248-449-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN OPHTHALMOLOGY SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "ZWICKER",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "313-530-5494"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.