NPIMap

Organization Active NPI

Bi County Ophthalmology PC

  • Ophthalmology Physician
  • Warren, MI
National Provider Identifier
1760668107
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
BI COUNTY OPHTHALMOLOGY PC
Practice address
28001 Schoenherr Rd
Suite 2
Warren, MI 48088-4396
Phone
(586) 756-5060
Fax
(586) 756-9783
NPI assigned
Jan 16, 2008
Last updated
Jan 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Authorized official

Name
Dr. Jesse J Cardellio, DO
Title
Owner/ President
Phone
(586) 756-5060

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 005215 MI
Optometrist 152W00000X
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

28001 Schoenherr Rd
Suite 2
Warren, MI 48088-4396

Mailing address

28001 Schoenherr Rd
Suite 2
Warren, MI 48088-4396
Phone (586) 756-5060

Other identifiers 1

IdentifierTypeStateIssuer
111536954MedicaidMI

National Provider Directory

National Provider Directory

Locations

13355 E 10 Mile Rd
Ste 116
Warren, MI 48089
Phone (586) 756-5060

NPI Registry JSON

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390953600000",
    "number": "1760668107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28001 SCHOENHERR RD",
            "address_2": "SUITE 2",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480884396",
            "telephone_number": "586-756-5060",
            "fax_number": "586-756-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28001 SCHOENHERR RD",
            "address_2": "SUITE 2",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480884396",
            "telephone_number": "586-756-5060",
            "fax_number": "586-756-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BI COUNTY OPHTHALMOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2014-01-29",
        "status": "A",
        "authorized_official_last_name": "CARDELLIO",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/ PRESIDENT",
        "authorized_official_telephone_number": "586-756-5060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": "005215",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111536954",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.