Active NPI
Karen Suzanne Deloss, O.D.
- Optometrist
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901004562
- Practice address
- 1000 Wall Street
Ann Arbor, MI 48105-1912 - Phone
- (734) 764-4190
- NPI assigned
- Oct 15, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 7302T | TX | |
| Optometrist | 152W00000X | 4901004562 | MI | Primary |
Addresses
Primary practice location
1000 Wall Street
Ann Arbor, MI 48105-1912
Mailing address
3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101029000790 | MI | Practitioner - Optometry | 1355403221 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2008
- 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
7500 Challis Rd
Brighton, MI 48116-9416
Phone (734) 764-4190
Hospital & facility affiliations
- University of Michigan Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7302T | TX | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of Michigan | Optometrist | Current | Accepting new patients |
| Regents of the University of Michigan | Current | Accepting new patients | |
| Regents of the University of Michigan | Past | Accepting new patients | |
| Regents of the University of Michigan | Past | Accepting new patients | |
| Regents of the University of Michigan | Past | Accepting new patients | |
| Regents of the University of Michigan | Past | Accepting new patients |
Locations
380 Parkland Plz
Ann Arbor, MI 48103
Phone (734) 615-3217
380 Parkland Plz
Ste 210
Ann Arbor, MI 48103
1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280
3621 S State St
#700
Ann Arbor, MI 48108
1000 Wall St
Ann Arbor, MI 48105
Phone (734) 763-1415
7500 Challis Rd
Brighton, MI 48116
Phone (734) 764-4190
39901 Traditions Dr
Ste 230
Northville, MI 48168
Phone (248) 305-4400
Interoperability endpoints
- kdeloss26520@direct.med.umich.edu
Organizations & group practices 6
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.
-
- Specialty Pharmacy
- Dexter, MI
- NPI 1952181919
-
- General Acute Care Hospital
- Ann Arbor, MI
- NPI 1003878539
-
- Eyewear Supplier
- Ann Arbor, MI
- NPI 1053818633
-
- Home Health Agency
- Ann Arbor, MI
- NPI 1063465607
-
- Eyewear Supplier
- Northville, MI
- NPI 1619474376
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Ann Arbor, MI
- NPI 1003878539
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277164800000",
"number": "1750533352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"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": "1000 WALL STREET",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481051912",
"telephone_number": "734-764-4190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELOSS",
"first_name": "KAREN",
"middle_name": "SUZANNE",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-15",
"last_updated": "2010-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "7302T",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901004562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.