Organization Active NPI

Glaucoma Eye Center PC

  • Ophthalmology Physician
  • Grand Rapids, MI
National Provider Identifier
1891855714
Registry record updated Mar 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
GLAUCOMA EYE CENTER PC
Practice address
2727 E Beltline Ave NE
Suite 101
Grand Rapids, MI 49525-9611
Phone
(616) 361-9205
Fax
(616) 361-9254
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2013

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

Authorized official

Name
Danny D Wang, M.D.NPI 1699703470
Title
President Owner
Phone
(616) 361-9205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2727 E Beltline Ave NE
Suite 101
Grand Rapids, MI 49525-9611

Mailing address

2727 E Beltline Ave NE
Suite 101
Grand Rapids, MI 49525-9611
Phone (616) 361-9205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041103000542 MI Part B Supplier - Clinic/Group Practice 0143282921 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Rapids, MI; Grandville, MI

National Provider Directory

National Provider Directory

Locations

2727 E Beltline Ave NE
Ste 101
Grand Rapids, MI 49525
Phone (616) 361-9205

2727 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 361-9205

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364083200000",
    "number": "1891855714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 E BELTLINE AVE NE",
            "address_2": "SUITE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259611",
            "telephone_number": "616-361-9205",
            "fax_number": "616-361-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 E BELTLINE AVE NE",
            "address_2": "SUITE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259611",
            "telephone_number": "616-361-9205",
            "fax_number": "616-361-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLAUCOMA EYE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2013-03-24",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "DANNY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "616-361-9205",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.