NPIMap

Organization Active NPI

Michigan Ophthalmology Specialists, PLLC

Doing business as Advanced Ophthalmology Associates

  • Ophthalmology Physician
  • Livonia, MI
National Provider Identifier
1942272364
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MICHIGAN OPHTHALMOLOGY SPECIALISTS, PLLC
Doing business as
Advanced Ophthalmology Associates
Clavenna Vision Institute
Fite Eye Center2 more in Other names
Practice address
33400 6 Mile Rd
Livonia, MI 48152-3165
Phone
(734) 421-2020
Fax
(734) 421-2290
NPI assigned
Feb 2, 2006
Last updated
Mar 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Authorized official

Name
Nossonal Kleinfeldt, MDNPI 1376540369
Title
Ceo
Phone
(734) 421-2020

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

33400 6 Mile Rd
Livonia, MI 48152-3165

Mailing address

30150 Telegraph Rd Ste 271
Bingham Farms, MI 48025-4521
Phone (248) 395-5175

Other identifiers 9

IdentifierTypeStateIssuer
104983299MedicaidMI
0M94750OtherMIWPS
104485008MedicaidMI
58117AOtherMIHEALTH ALLIANCE PLAN OF M
104638662MedicaidMI
C30473OtherMIPALMETTO GBA
104966799MedicaidMI
180H270190OtherMIBLUE CARE NETWORK
180H270190OtherMIBLUE CROSS BLUE SHIELD

Other names 6

  • Advanced Ophthalmology Associates Doing business as
  • Clavenna Vision Institute Doing business as
  • Fite Eye Center Doing business as
  • Ophthalmic Specialists of Michigan Doing business as
  • Rohr Eye & Laser Center Doing business as
  • Coburn Kleinfeldt Eye Clinic PC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414001332 MI Part B Supplier - Clinic/Group Practice 3577557131 Receives reassigned benefits from 30 practitioners
Practice locations: Novi, MI; Romeo, MI; Pontiac, MI; Royal Oak, MI; Shelby Township, MI; Shelby TWP, MI; Southfield, MI; Southgate, MI…

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

330 E 14 Mile Rd
Ste B
Clawson, MI 48017
Phone (248) 589-9500

24241 Michigan Ave
Spc Mi
Dearborn, MI 48124

24800 Michigan Ave
Dearborn, MI 48124
Phone (313) 561-7255

33400 6 Mile Rd
Spc Mi
Livonia, MI 48152

33400 6 Mile Rd
Ste A
Livonia, MI 48152
Phone (734) 452-7111

301 W 13 Mile Rd
Spc Mi
Madison Heights, MI 48071

67960 Van Dyke Rd
Romeo, MI 48065
Phone (586) 336-1279

47670 Van Dyke Ave
Shelby Township, MI 48317
Phone (586) 250-2972

Interoperability endpoints

  • Direct secure messaging: aamirikia@osm.intellechartdirect.net
  • Direct secure messaging: akellis@osm.intellechartdirect.net
  • Direct secure messaging: carriehappsmith@osm.intellechartdirect.net
  • Direct secure messaging: cgustin@osm.intellechartdirect.net
  • Direct secure messaging: czenzen@osm.intellechartdirect.net
  • Direct secure messaging: dstlouis@osm.intellechartdirect.net
  • Direct secure messaging: enichols@osm.intellechartdirect.net
  • Direct secure messaging: geippert@osm.intellechartdirect.net
  • Direct secure messaging: gjohnson@osm.intellechartdirect.net
  • Direct secure messaging: griffle@osm.intellechartdirect.net
  • Direct secure messaging: jkuta@osm.intellechartdirect.net
  • Direct secure messaging: jlangel@osm.intellechartdirect.net
  • Direct secure messaging: jrautio@osm.intellechartdirect.net
  • Direct secure messaging: jrosenberg@osm.intellechartdirect.net
  • Direct secure messaging: khess@osm.intellechartdirect.net
  • Direct secure messaging: llim@osm.intellechartdirect.net
  • Direct secure messaging: lward@osm.intellechartdirect.net
  • Direct secure messaging: mlieb@osm.intellechartdirect.net
  • Direct secure messaging: mtakacs@osm.intellechartdirect.net
  • Direct secure messaging: salbear@osm.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 44

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.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1942272364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30150 TELEGRAPH RD STE 271",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254521",
            "telephone_number": "248-395-5175",
            "fax_number": "248-395-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33400 6 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523165",
            "telephone_number": "734-421-2020",
            "fax_number": "734-421-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN OPHTHALMOLOGY SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "KLEINFELDT",
        "authorized_official_first_name": "NOSSONAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-421-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104983299",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS",
            "identifier": "0M94750",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104485008",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN OF M",
            "identifier": "58117A",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104638662",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "C30473",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104966799",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "180H270190",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "180H270190",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Ophthalmology Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clavenna Vision Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fite Eye Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ophthalmic Specialists of Michigan",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rohr Eye & Laser Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coburn Kleinfeldt Eye Clinic PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Coburn Kleinfeldt Eye Clinic PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.