Individual provider Active NPI

Richard J Roose, O.D.

  • Optometrist
  • Troy, MI
National Provider Identifier
1851436505
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003893 Issued in MI
Practice address
300 W 14 Mile Rd
Troy, MI 48083-4218
Phone
(248) 585-5212
Fax
(248) 585-0355
NPI assigned
Feb 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003893 MI Primary

Addresses

Primary practice location

300 W 14 Mile Rd
Troy, MI 48083-4218

Mailing address

300 W 14 Mile Rd
Troy, MI 48083-4218
Phone (248) 585-5212

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140605001309 MI Practitioner - Optometry 5193949568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SVS Vision IncGroup PAC ID 9931257110, 41 clinicians

Practice addresses (Care Compare)

118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 468-7612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901003893MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
SVS Vision Inc Optometrist CurrentSince May 1, 2014 Accepting new patients
SVS Vision Inc Optometrist CurrentSince May 1, 2014 Accepting new patients

Locations

34505 Utica Rd
Fraser, MI 48026
Phone (586) 293-4198

2023 W 8 Mile Rd
Highland Park, MI 48203
Phone (313) 365-3300

106 W 12 Mile Rd
Madison Heights, MI 48071
Phone (248) 414-1900

118 Cass Ave
Mount Clemens, MI 48043
Phone (586) 464-1479

22320 Goddard Rd
Taylor, MI 48180
Phone (313) 299-8870

5761 E 12 Mile Rd
Warren, MI 48092
Phone (586) 619-3600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851436505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W 14 MILE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480834218",
            "telephone_number": "248-585-5212",
            "fax_number": "248-585-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 14 MILE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480834218",
            "telephone_number": "248-585-5212",
            "fax_number": "248-585-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOSE",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.