Active NPI
Yaakov Gershon Zacks, OD
- Optometrist
- Southfield, MI
National Provider Identifier
1720197759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901004402
- Practice address
- 16232 Sherfield PL
Southfield, MI 48075-2061 - Phone
- (248) 376-6046
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901004402 | MI | Primary |
Addresses
Primary practice location
16232 Sherfield PL
Southfield, MI 48075-2061
Mailing address
16232 Sherfield PL
Southfield, MI 48075-2061
Phone (248) 552-1323
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4553823 | Medicaid | MI |
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 2006
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
16232 Sherfield PL
Southfield, MI 48075-2061
Phone (248) 376-6046
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- yaakov@eyetravel.ssdirect.aprima.com
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.
-
- Ophthalmology Physician
- Southfield, MI
- NPI 1982709861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436140800000",
"number": "1720197759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16232 SHERFIELD PL",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752061",
"telephone_number": "248-552-1323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16232 SHERFIELD PL",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752061",
"telephone_number": "248-376-6046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZACKS",
"first_name": "YAAKOV",
"middle_name": "GERSHON",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2015-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901004402",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4553823",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.