NPIMap

Organization Active NPI

Family Optometry Associates, PC

  • Optometrist
  • Troy, MI
National Provider Identifier
1972674992
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002367 Issued in MI
Legal business name
FAMILY OPTOMETRY ASSOCIATES, PC
Practice address
2950 E Wattles Rd
Suite 100
Troy, MI 48085-7008
Phone
(248) 740-0222
Fax
(248) 689-0123
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Authorized official

Name
Dr. Philip David Cohen, O.DNPI 1235189382
Title
Doctor
Phone
(248) 740-0222

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4901002367 MI Primary

Addresses

Primary practice location

2950 E Wattles Rd
Suite 100
Troy, MI 48085-7008

Mailing address

2950 E Wattles Rd
Suite 100
Troy, MI 48085-7008
Phone (248) 740-0222

Other identifiers 3

IdentifierTypeStateIssuer
900F36621OtherMIBLUE CROSS BLUE SHEILD
1876473MedicaidMI
$$$$$$$$$OtherMISSN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1972674992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 E WATTLES RD",
            "address_2": "SUITE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480857008",
            "telephone_number": "248-740-0222",
            "fax_number": "248-689-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 E WATTLES RD",
            "address_2": "SUITE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480857008",
            "telephone_number": "248-740-0222",
            "fax_number": "248-689-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY OPTOMETRY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "248-740-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "900F36621",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1876473",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSN",
            "identifier": "$$$$$$$$$",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.