NPIMap

Organization Active NPI

Vitreo-Retinal Consultants, P.C.

  • Specialist
  • Clinton Township, MI
National Provider Identifier
1902071251
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301036034 Issued in MI
Legal business name
VITREO-RETINAL CONSULTANTS, P.C.
Practice address
43800 Garfield Rd
Suite 100
Clinton Township, MI 48038-1136
Phone
(586) 228-8400
Fax
(586) 228-7031
NPI assigned
Apr 28, 2008
Last updated
Apr 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Dr. Howard Charles Joondeph, M.D.
Title
Owner
Phone
(586) 228-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 4301036034 MI Primary

Addresses

Primary practice location

43800 Garfield Rd
Suite 100
Clinton Township, MI 48038-1136

Mailing address

43800 Garfield Rd
Suite 100
Clinton Township, MI 48038-1136
Phone (586) 228-8400

Other identifiers 1

IdentifierTypeStateIssuer
1310966MedicaidMI

National Provider Directory

National Provider Directory

Locations

43800 Garfield Rd
Ste 100
Clinton Twp, MI 48038
Phone (586) 228-8400

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1902071251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43800 GARFIELD RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381136",
            "telephone_number": "586-228-8400",
            "fax_number": "586-228-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43800 GARFIELD RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381136",
            "telephone_number": "586-228-8400",
            "fax_number": "586-228-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITREO-RETINAL CONSULTANTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "JOONDEPH",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-228-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301036034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1310966",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.