Retina Specialists Of Michigan PC

Ophthalmology, Retina Specialist in Grand Rapids, MI. Organization (NPI-2).

NPI number1801048699

StatusActive

Last updated in NPPESJun 6, 2022

Details

NPI: 1801048699
Entity type: Organization (NPI-2)
Legal business name: Retina Specialists Of Michigan PC
Organization subpart: No
Enumeration date: Oct 13, 2008
Certification date: Jun 6, 2022
Last updated: Jun 6, 2022

Medicare and OIG

Medicare enrolled (PECOS): Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207WX0107X	Ophthalmology, Retina Specialist	–	–	Yes
207W00000X	Ophthalmology	4301077476	MI

Practice location

5030 Cascade Rd Se
Grand Rapids, MI 49546-3725

Phone 616-954-2020 · Fax 616-949-0408

Mailing address

5030 Cascade Rd Se
Grand Rapids, MI 49546-3725

Phone 616-954-2020 · Fax 616-949-0408

Authorized official

Heather Duhr
Executive Director
6164667562

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Retina Specialist (Ophthalmology) Physician providers in Grand Rapids, MI

All 8 Retina Specialist (Ophthalmology) Physician providers in Grand Rapids · All 20,987 providers in Grand Rapids

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