Elowsky Eyecare PC
Organization Active NPI Optometrist · Cheboygan, MI
NPI 1811306152 · NPPES record last updated Aug 12, 2014
Key facts
- NPI
- 1811306152
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901004788 (MI)
- Legal business name
- ELOWSKY EYECARE PC
- Practice address
- 730 S Main St
Cheboygan, MI 49721-2220 - Phone
- (231) 627-5666
- Fax
- (231) 627-5487
- NPI assigned
- Aug 12, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Travis James Elowsky, O.D.
- Title
- Doctor of Optometry
- Phone
- (989) 916-5544
Practitioners 3
-
Travis James Elowsky, O.D.
-
Edward Paul Kosanke, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141203002659 | MI | Part B Supplier - Clinic/Group Practice | 2365764263 |
Receives reassigned benefits from 1 practitioner Practice locations: Cheboygan, MI; Indian River, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 4901004788 | MI | Yes |
Addresses
Primary practice location
730 S Main St
Cheboygan, MI 49721-2220
Mailing address
730 S Main St
Cheboygan, MI 49721-2220
Phone (231) 627-5666
Other providers in Cheboygan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.