Active NPI
Walter Stanley Cukrowski II, M.D.
- Ophthalmology Physician
- Royal Oak, MI
National Provider Identifier
1962419283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- WC028570
- Practice address
- 32000 Woodward Ave
Suite a
Royal Oak, MI 48073-0998 - Phone
- (248) 549-6000
- Fax
- (248) 549-4923
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | WC028570 | MI | Primary |
Addresses
Primary practice location
32000 Woodward Ave
Suite a
Royal Oak, MI 48073-0998
Mailing address
32000 Woodward Ave
Suite a
Royal Oak, MI 48073-0998
Phone (248) 549-6000
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1806338551 | Other | MI | BCBS |
| B0900 | Other | MI | MCARE |
| P41060 | Other | MI | BLUE CARE NETWORK |
| 4285676 | Other | MI | AETNA |
| 2355976004 | Other | MI | CIGNA |
| 4416216 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WC028570 | MI | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962419283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32000 WOODWARD AVE",
"address_2": "SUITE A",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480730998",
"telephone_number": "248-549-6000",
"fax_number": "248-549-4923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32000 WOODWARD AVE",
"address_2": "SUITE A",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480730998",
"telephone_number": "248-549-6000",
"fax_number": "248-549-4923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUKROWSKI",
"first_name": "WALTER",
"middle_name": "STANLEY",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MI",
"license": "WC028570",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1806338551",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCARE",
"identifier": "B0900",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK",
"identifier": "P41060",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4285676",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2355976004",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4416216",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.