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
Last updated
Oct 16, 2023By the provider in NPPES
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 Physician 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 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

600 S Adams Rd
Ste 200
Birmingham, MI 48009
Phone (248) 646-3733

16530 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 226-2020

19176 Hall Rd
Ste 110
Clinton Twp, MI 48038
Phone (586) 286-3400

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

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

5202 Miller Rd
Flint, MI 48507
Phone (810) 720-8900

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

44555 Woodward Ave
Ste 203
Pontiac, MI 48341
Phone (248) 334-4931

67960 Van Dyke Rd
Romeo, MI 48065
Phone (586) 336-1279

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

415 E Maple Rd
Ste 100
Troy, MI 48083
Phone (248) 526-1010

Practitioners & affiliated clinicians

Practitioners 28

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.

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": "",
            "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.