GREAT LAKES EYE INSTITUTE (NPI# 1063680791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063680791 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES EYE INSTITUTE |
| Practice Address |
2393 Schust Rd Saginaw MI 48603-1334 |
| Practice Telephone | 9897932820 |
| Practice Fax Number | 9897939132 |
| Mailing Telephone | 9897932820 |
| Mailing Fax Number | 9897939132 |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2018-01-23 |
| Authorized Official Name | FARHAD K SHOKOOHI (OWNER/MD) |
| Authorized Official Telephone | 9897932820 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| Y | 207W00000X | Ophthalmology | 4301040619 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CARE NETWORK | 180G310710 | 01 |
| MEDICARE | 0N11610 | 01 | |
| MI | BLUE CARE NETWORK | 180G300890 | 01 |
| MEDICARE | 0G36036 | 01 | |
| MI | BLUE CROSS BLUE SHIELD | 180G300890 | 01 |
| MI | BLUE CROSS BLUE SHIELD | 180G310710 | 01 |
| RAILROAD MEDICARE | CA3610 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003437823 | Great Lakes Eye Institute | Ophthalmology | 800 Woodside Ave, Bay City, MI 48708-5468 | 2020-05-04 |
| 1447434378 | Great Lakes Eye Institute | Optometrist | 4624 Hill St, Cass City, MI 48726-1119 | 2007-12-27 |
| 1841474772 | Great Lakes Eye Institute | Optometrist | 406 W Genesee St, Frankenmuth, MI 48734-1311 | 2007-12-27 |
| 1346424272 | Great Lakes Eye Institute | Optometrist | 623 W Warwick Dr, Suite 1, Alma, MI 48801-1177 | 2007-12-27 |
| 1992985840 | Great Lakes Eye Institute | Optometrist | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2007-11-08 |
| 1427090976 | Great Lakes Eye Institute | Ophthalmology | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2006-06-11 |
| Street Address |
2393 SCHUST RD |
| City | SAGINAW |
| State | MI |
| Zip Code | 48603-1334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518961556 | Brian D. Dudenhoefer | Ophthalmology | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2005-06-08 |
| 1295180214 | Nicholas David Shokoohi | Ophthalmology | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2016-04-27 |
| 1528329489 | Victoria Ayn Williams | Ophthalmology | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2012-06-06 |
| 1699939751 | Kristine Marie Weaver | Optometrist | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2008-07-17 |
| 1073798211 | Great Lakes Eye Surgery Center LLC | Clinic/Center | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2008-01-07 |
| 1992985840 | Great Lakes Eye Institute | Optometrist | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2007-11-08 |
| 1265542849 | Great Lakes Eye Surgery Center LLC | Clinic/Center | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2006-08-30 |
| 1689685463 | Moonyoung S Chung | Ophthalmology | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2006-08-10 |
| 1780602763 | Scott M Vandenbelt | Ophthalmology | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2006-07-17 |
| 1427090976 | Great Lakes Eye Institute | Ophthalmology | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2006-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518503952 | Kimberly Michelle Cole | Social Worker | 2823 Pimlico Ln, Saginaw, MI 48603 | 2019-11-20 |
| 1669035895 | Kristine Anna Roberts | Massage Therapist | 3175 Christy Way 8, Saginaw, MI 48603 | 2019-04-14 |
| 1114413069 | Sabrina Shunnarah | Behavioral Analyst | 3267 Schust Road, Apt. 101, Saginaw, MI 48603 | 2018-07-03 |
| 1740708528 | Alexandra Jennette Hengy | Student in an Organized Health Care Education/Training Program | 4287 Harbour Towne Dr Apt. 6, Saginaw, MI 48603 | 2017-08-31 |
| 1003345380 | Karissa Irene Piar | Social Worker | 2100 Hemmeter Rd., Saginaw, MI 48603 | 2017-06-08 |
| 1922537281 | Anita Rick | Behavior Technician | 3949 N. River Road, Freeland, Mi 48623, Freeland, MI 48603 | 2017-06-08 |
| 1417300393 | Saginaw County Community Mental Health Authority | In Home Supportive Care | 3875 Bay Rd., Saginaw, MI 48603 | 2016-07-15 |
| 1992154009 | Tricity Diagnostics, LLC | Physiological Laboratory | 3055 Enterprise Drive, Suite 2, Saginaw, MI 48603 | 2016-06-09 |
| 1659744571 | Janet Lee Smith | Social Worker | 4341 Barnard Rd, Saginaw, MI 48603 | 2015-11-02 |
| 1255656757 | Joseph Edward Chmielewski | Chiropractor | 4266 State St., Saginaw, MI 48603 | 2010-03-29 |
| Find all providers in zip 48603 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699781443 | Ingeborg E Kirch | Ophthalmology | 5161 Cardinal Park Dr, Saginaw, MI 48604-9435 | 2006-08-01 |
| 1801889662 | David B Krebs | Ophthalmology | 5310 Hampton Pl, Suite 2, Saginaw, MI 48604-8202 | 2005-08-26 |
| 1043202948 | Usha Kurumety Bulusu | Ophthalmology | 2489 Trautner Dr, Saginaw, MI 48604-9596 | 2005-08-17 |
| 1639174725 | Miriam T Schteingart | Ophthalmology | 5161 Cardinal Park Drive, Saginaw, MI 48604-9435 | 2005-06-16 |
| 1518961556 | Brian D. Dudenhoefer | Ophthalmology | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2005-06-08 |
| 1295180214 | Nicholas David Shokoohi | Ophthalmology | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2016-04-27 |
| 1437561958 | Melanie Lynn Mihlstin | Ophthalmology | 5161 Cardinal Park Dr, Saginaw, MI 48604 | 2014-06-02 |
| 1528329489 | Victoria Ayn Williams | Ophthalmology | 2393 Schust Rd, Saginaw, MI 48603-1334 | 2012-06-06 |
| 1417124132 | Envision Eye Care Pllc | Ophthalmology | 5310 Hampton Pl, Suite 2, Saginaw, MI 48604-8202 | 2008-05-12 |
| 1689898173 | Eric Scott Collier | Ophthalmology | 5161 Cardinal Park Drive, Saginaw, MI 48604-9435 | 2007-04-13 |
| Find all providers in SAGINAW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.