Individual provider Active NPI

Bruce Alan Pate, O.D.

  • Optometrist
  • Durham, NC
National Provider Identifier
1003805565
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1962 Issued in NC
Practice address
2900 Croasdaile Dr
Ste. 6
Durham, NC 27705-2579
Phone
(919) 683-2020
NPI assigned
Oct 18, 2005
Last updated
Mar 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1962 NC Primary

Addresses

Primary practice location

2900 Croasdaile Dr
Ste. 6
Durham, NC 27705-2579

Mailing address

2900 Croasdaile Dr
Ste. 6
Durham, NC 27705-2579

Other identifiers 2

IdentifierTypeStateIssuer
093TXOtherNCBCBS
5901433MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050525000945 NC Practitioner - Optometry 9133161508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2900 Croasdaile Dr
Suite 6
Durham, NC 27705-2579
Phone (919) 683-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1962NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Center, P.a. CurrentSince Dec 9, 1974 Accepting new patients

Locations

2900 Croasdaile Dr
Durham, NC 27705
Phone (919) 383-7402

2900 Croasdaile Dr
Ste 6
Durham, NC 27705
Phone (919) 683-2020

349 Ja Max Dr
Hillsborough, NC 27278
Phone (919) 732-2020

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1003805565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CROASDAILE DR",
            "address_2": "STE. 6",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277052579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CROASDAILE DR",
            "address_2": "STE. 6",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277052579",
            "telephone_number": "919-683-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATE",
        "first_name": "BRUCE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "093TX",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901433",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.