BLUE WATER EYE CARE ASSOCIATES PC (NPI# 1104081819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104081819 |
Entity Type | Organization |
Organization Name | BLUE WATER EYE CARE ASSOCIATES PC |
Practice Address |
2609 Electric Ave Suite A Port Huron MI 48060-6589 |
Practice Telephone | 8109821300 |
Practice Fax Number | 8109829802 |
Mailing Telephone | 8109821300 |
Mailing Fax Number | 8109829802 |
Enumeration Date | 2008-07-22 |
Last Update Date | 2020-02-20 |
Authorized Official Name | KATY S BROCHU (BILLING) |
Authorized Official Telephone | 8109821300 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
Street Address |
2609 ELECTRIC AVE SUITE A |
City | PORT HURON |
State | MI |
Zip Code | 48060-6589 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659328664 | Associated Retinal Consultants, PC | Ophthalmology | 2609 Electric Ave, A, Port Huron, MI 48060-6589 | 2006-05-27 |
1609118637 | Alexis Johnson | Counselor | 2609 Electric Ave, Ste A, Port Huron, MI 48060-6589 | 2013-03-16 |
1114236353 | Mercy Surgery Care Network | Surgery | 2609 Electric Ave, Suite B, Port Huron, MI 48060-6589 | 2010-10-06 |
1871667071 | Walid Demashkieh | Surgery | 2609 Electric Ave, Suite B, Port Huron, MI 48060-6589 | 2006-11-20 |
1427146091 | St Clair Surgical Group PC | Surgery | 2609 Electric Ave, Suite C, Port Huron, MI 48060 | 2006-10-10 |
1902905631 | James W Copping Jr. | Surgery | 2609 Electric Ave, Suite C, Port Huron, MI 48060 | 2006-09-21 |
1184721599 | Kevin D Johnson | Ophthalmology | 2609 Electric Ave, Ste. A, Port Huron, MI 48060-6589 | 2006-09-20 |
1093824013 | Krishna D Valjee | Surgery | 2609 Electric Ave, Suite C, Port Huron, MI 48060-6589 | 2006-08-30 |
1003925033 | Dawn Elaine Morey | Surgery | 2609 Electric Ave, Ste B, Port Huron, MI 48060-6589 | 2006-08-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740897297 | Casey Edward Bicker | Behavior Technician | 3245 Keewahdin Rd; Fort Gratiot, Mi 48059, Port Huron, MI 48060 | 2020-09-29 |
1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
1982123006 | Kenneth Shine Heuvelman | Counselor | 3522 Holland Park Ln, Port Huron, MI 48060 | 2017-09-11 |
1346767506 | Kelly Baker | Social Worker | 520 Superior St., Port Huron, MI 48060 | 2017-08-28 |
1326418609 | Jean Burleigh | Chore Provider | 614 Staton, Port Huron, MI 48060 | 2015-09-30 |
1205242161 | Lisa Gray | Counselor | 2885 W Rick Dr, Port Huron, MI 48060 | 2014-07-10 |
1861758880 | Aaron Overly | Surgery | 2609 Electric Ave Ste B&, Port Huron, MI 48060 | 2012-04-03 |
1942591508 | S Akram Ali | Surgery | 3270 Waldheim Dr, Port Huron, MI 48060 | 2011-04-29 |
1417258179 | Nicholas Alexander Tobianski | Physician Assistant | 3550 Pine Grove Avenue, Port Huron, MI 48060 | 2010-11-11 |
1598092769 | Blue Water Pharmacy LLC | Pharmacy | 1524 10th Street, Port Huron, MI 48060 | 2009-11-10 |
Find all providers in zip 48060 |
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 |
---|---|---|---|---|
1437260197 | Norbert P Czajkowski, Md, PC | Ophthalmology | 1000 Pine Grove Ave, Port Huron, MI 48060-3733 | 2006-08-31 |
1659328664 | Associated Retinal Consultants, PC | Ophthalmology | 2609 Electric Ave, A, Port Huron, MI 48060-6589 | 2006-05-27 |
1639130024 | Brian Val Favero | Ophthalmology | 1033 River St, Suite 2, Port Huron, MI 48060-3463 | 2006-03-28 |
1588659593 | Scott W Barton | Ophthalmology | 1000 Pine Grv, Port Huron, MI 48060-3733 | 2005-09-15 |
1134254071 | Eye Care Providers of Michigan PC | Ophthalmology | 1000 Pine Grove Ave, Port Huron, MI 48060-3733 | 2007-02-22 |
1184721599 | Kevin D Johnson | Ophthalmology | 2609 Electric Ave, Ste. A, Port Huron, MI 48060-6589 | 2006-09-20 |
1376558122 | Port Huron Ophthalmology, Pllc | Ophthalmology | 1033 River St, Port Huron, MI 48060-3463 | 2006-07-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649894429 | Ryan Freedman | Ophthalmology | 2250 Providence Dr., 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-08 |
1457973018 | Neha Gupta | Ophthalmology | 1134 Woburn Grn, Bloomfield Hills, MI 48302-2300 | 2020-05-17 |
1003437823 | Great Lakes Eye Institute | Ophthalmology | 800 Woodside Ave, Bay City, MI 48708-5468 | 2020-05-04 |
1447899273 | Legacy Eye Institute Plc | Ophthalmology | 811 East Street, Lapeer, MI 48446-3033 | 2019-12-26 |
1013471515 | Marshall Ophthalmology, Pllc | Ophthalmology | 16468 Emily Corlett, Marshall, MI 49068-8323 | 2019-01-29 |
1023583564 | Rochester Ophthalmology, Pllc | Ophthalmology | 1135 W University Dr Ste 155, Rochester, MI 48307-1871 | 2018-10-11 |
1205301983 | Grand Blanc Opthalmology | Ophthalmology | 123 South Westnedge Ave, Kalamazoo, MI 49007-6420 | 2018-10-09 |
1548756141 | Marko Habekovic Md, Pllc | Ophthalmology | 1000 E Paris Ave Se Ste 111, Grand Rapids, MI 49546-3680 | 2018-07-06 |
1487189254 | Yaldo Eye Centers PC | Ophthalmology | 31535 Ford Rd, Garden City, MI 48135-1821 | 2017-04-28 |
1366895005 | Black & White Look Optical Corp | Ophthalmology | 15675 W 10 Mile Rd, Southfield, MI 48075-2188 | 2016-07-18 |
Find all providers with the same taxonomy |
City | PORT HURON |
Zip Code | 48060 |
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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.