WAYNE STATE UNIVERSITY PHYSICIAN GROUP
NPI 1063452233
Optometrist in Detroit, MI
About Wayne State University Physician Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WAYNE STATE UNIVERSITY PHYSICIAN GROUP (NPI 1063452233) is a healthcare organization registered as an optometrist in Detroit, Michigan and active in the NPI registry since June 2006. The organization holds 2 active CLIA laboratory certificates and lists Jeffery P Kohlitz, Chief Financial Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 8
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Wayne State University Physician Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
728Medicare enrollment records show 728 clinicians reassign Medicare billing to Wayne State University Physician Group, which bills Medicare for the services they deliver. Of these, 448 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 53
Nearest to this location (20)
See all 728Detroit, MI 48201
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 23D1004406
Wayne State University Physician Group · Detroit, MICertificate of Waiver 23D2328918
Wayne State University · Detroit, MIFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is University Physician Group's NPI number?
The NPI number for University Physician Group is 1063452233. It was assigned to this organization in the NPPES registry on June 7, 2006. The provider is doing business as Wayne State University Physician Group.
Where is University Physician Group located?
University Physician Group is located at 4717 Saint Antoine St, Detroit, MI 48201. The listed phone number is (313) 577-8900.
What is University Physician Group's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is University Physician Group enrolled in Medicare?
Yes. University Physician Group is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through University Physician Group?
According to the CMS Revalidation Reassignment List (October 2026 release), 728 clinicians in 53 Medicare specialties reassign their Medicare billing to University Physician Group. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (124), Internal Medicine (90) and Ophthalmology (58). Of these, 448 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does University Physician Group hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does University Physician Group accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee list University Physician Group as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for University Physician Group was last updated on October 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Wayne State University Physician Group · NPI 1063452233
Optometrist organization in Detroit, Michigan. Organization record, active in the CMS NPPES registry since June 7, 2006.
## Identity
- **NPI:** 1063452233 (Entity type: Organization)
- **Enumerated:** June 7, 2006
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Legal business name:** University Physician Group
- **Organization subpart:** No
- **Authorized official:** Jeffery Kohlitz, CHIEF FINANCIAL OFFICER
## Practice location
- **Address:** 4717 SAINT ANTOINE ST, Detroit, MI 48201-1423
- **Phone:** (313) 577-8900 · **Fax:** (313) 577-0700
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 728 clinicians in 53 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (124), Internal Medicine (90), Ophthalmology (58); 448 practice within 10 miles; [full list](https://npiprofile.com/npi/1063452233/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 26, 2016
- **Other identifiers:** Other 0H22869 (MI); Other 0P32140 (MI); Medicare NSC 5717980003 (MI); and 5 more
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1063452233) · Data from the CMS NPPES public registry.