Rosedale Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

ROSEDALE EYECARE

Practice address

19460 Grand River
Detroit, MI 48223

Phone

(313) 533-4003

NPI assigned

Dec 15, 2006

Organization subpart

No

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

Authorized official

Name

Derrick Ray Martin

Title

VP

Phone

(313) 533-4003

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• RoseDale Eyecare LLC Other name

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1902968837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19460 GRAND RIVER",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48223",
            "telephone_number": "313-533-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19460 GRAND RIVER",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48223",
            "telephone_number": "313-533-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEDALE EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "313-533-4003"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": "4901002131",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4J10880",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RoseDale Eyecare LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Blandina Margaret Rose-Willis, MED, PHD
• Kathryn Rose, WHNP
• Roseberry Adult Foster Care
• Roderick Roseberry, SST
• Rosedale Community Pharmacy Inc
• Rosedale Vision
• Rosedale Vision
• Ronald David Roseman, PHYSICAL THERAPIST
• Rosemary Brown PLLC
• Rosemond Chiropractic Health Center, Inc

• Optometrist in Detroit, MI
• Providers in Detroit, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.