Individual provider Active NPI

Daniel Anthony Arsulowicz, O.D.

  • Optometrist
  • Grand Rapids, MI
National Provider Identifier
1982762241
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901002358 Issued in MI
Practice address
3935 Lake Michigan Dr NW
Grand Rapids, MI 49534-7844
Phone
(616) 453-8223
Fax
(616) 453-6262
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901002358 MI Primary

Addresses

Primary practice location

3935 Lake Michigan Dr NW
Grand Rapids, MI 49534-7844

Mailing address

3935 Lake Michigan Dr NW
Grand Rapids, MI 49534-7844
Phone (616) 453-8223

Other identifiers 1

IdentifierTypeStateIssuer
900D16546OtherMIBLUE CROSS BLUE SHIELD

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1982762241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3935 LAKE MICHIGAN DR NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495347844",
            "telephone_number": "616-453-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3935 LAKE MICHIGAN DR NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495347844",
            "telephone_number": "616-453-8223",
            "fax_number": "616-453-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARSULOWICZ",
        "first_name": "DANIEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "900D16546",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.