WAYNE STATE UNIVERSITY PHYSICIAN GROUP
NPI 1114384757
Eyewear Supplier in Southfield, MI

Active since January 27, 2016
26400 W 12 MILE RD, SUITE 60, SOUTHFIELD, MI 48034(248) 594-6702(248) 594-6738 Get Directions Write a Review

NPPES record last updated: December 1, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 18, 2016, Jan 27, 2016 (2 updates tracked since 2016).

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 1114384757) is a healthcare organization registered as an eyewear supplier in Southfield, Michigan and active in the NPI registry since January 2016. The organization lists Jeffery P Kohlitz, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1114384757
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameUNIVERSITY PHYSICIAN GROUP
Location Address26400 W 12 MILE RD, SUITE 60Southfield, MI 48034-1774
Mailing Address1560 E. Maple Rd., Suite 400-credentialingTroy, MI 48083-1138 · (248) 581-5973 · Fax (248) 581-5640
Fax(248) 594-6738
Organization SubpartNo
Authorized OfficialJeffery P KohlitzChief Financial Officer · (248) 581-5930
Enumeration DateJanuary 27, 2016
Last NPPES UpdateDecember 1, 20162 updates tracked since enumeration
NPI 1114384757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
License Licensed in MI · 4301054761
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
26400 W 12 MILE RD, Southfield, MI 48034

Other Names 1

Doing Business AsWayne State University Physician Group

Other Identifiers 2

Medicare NSC5717980008MI
Other5717980008MI · Ngs

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories University Physician Group carries, from the Medicare DMEPOS supplier directory.

University Physician Group

DMEPOS supplier · Southfield, MI

Accepts Medicare assignment

University Physician Group agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20306483
Medicare Participant SinceApril 24, 2023
Supplier Location26400 W 12 Mile Rd Ste 60Southfield, MI 48034
Supplier Specialties
Optometrist

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses
Conventional Contact Lenses
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Neurology)
26400 W 12 MILE RD, STE 170
SOUTHFIELD, MI 48034
Urology
26400 W 12 MILE RD, SUITE 70
SOUTHFIELD, MI 48034
Dermatology (MOHS-Micrographic Surgery)
26400 W 12 MILE RD, SUITE 180
SOUTHFIELD, MI 48034
Ophthalmology
26400 W 12 MILE RD, STE 60
SOUTHFIELD, MI 48034
Specialist
26400 W 12 MILE RD, STE 38
SOUTHFIELD, MI 48034
Psychiatry & Neurology (Neurology)
26400 W 12 MILE RD, SUITE 170
SOUTHFIELD, MI 48034
Internal Medicine (Cardiovascular Disease)
26400 W 12 MILE RD, SUITE 120
SOUTHFIELD, MI 48034
Preventive Medicine (Occupational Medicine)
26400 W 12 MILE RD, SUITE 111
SOUTHFIELD, MI 48034

Frequently 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 1114384757. It was assigned to this organization in the NPPES registry on January 27, 2016. The provider is doing business as Wayne State University Physician Group.

Where is University Physician Group located?

University Physician Group is located at 26400 W 12 Mile Rd Suite 60, Southfield, MI 48034. The listed phone number is (248) 594-6702.

What is University Physician Group's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Does University Physician Group accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, University Physician Group accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

When was this NPI record last updated?

The NPPES record for University Physician Group was last updated on December 1, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.