Michael R Barnett, OD – Optometrist in Lilburn, GA

Key facts

NPI: 1003892019
Entity type: Individual (NPI type 1)
Primary specialty: Optometrist 152W00000X
License: 728T (GA)
Practice address: 4319 A Lawrenceville Hwy
Lilburn Eyecare
Lilburn, GA 30047
Phone: (770) 921-4707
Fax: (770) 925-8973
NPI assigned: Dec 21, 2005
Sex: Male
Sole proprietor: No

Organizations & group practices 3

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

Clarkson Optometry Georgia Inc Optometrist · Alpharetta, GA · NPI 1184802670

Medicare reassignment NPD GA · OPTOMETRIST
DRS. Barnett, Andersen, & Associates, Optometrist, P.C. Optometrist · Lilburn, GA · NPI 1073668307

NPD (past) OPTOMETRIST
State of Mississippi - University of Mississippi Medical Center Critical Access Hospital · Lexington, MS · NPI 1386630705

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in GA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20121016000605	GA	Practitioner - Optometry	6204943210	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
728T	GA	MD	Optometrist

Practice roles

Organization	Specialty	Status	New patients
Clarkson Optometry Georgia Inc	Optometrist	Current since Jul 1, 2017	Accepting new patients
DRS. Barnett, Andersen, & Associates, Optometrist, P.C.	Optometrist	Past since May 7, 1993	Accepting new patients
State of Mississippi - University of Mississippi Medical Center		Past	Accepting new patients

Locations

8400 Holcomb Bridge Rd
Ste 440
Alpharetta, GA 30022
Phone (770) 645-1222

4319 Lawrenceville Hwy NW
Lilburn, GA 30047
Phone (678) 583-8888

4319 Lawrenceville Hwy NW
Ste A
Lilburn, GA 30047
Phone (404) 921-4704

15933 Clayton Rd
Ste 201
Ballwin, MO 63011

Interoperability endpoints

Direct secure messaging: mbarnett@direct.eyecare-partners.com
FHIR API: https://app.meldrx.com/api/fhir/ecp_cecga

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Optometrist	152W00000X	728T	GA	Yes

Addresses

Primary practice location

4319 A Lawrenceville Hwy
Lilburn Eyecare
Lilburn, GA 30047

Mailing address

4319 A Lawrenceville Hwy
Lilburn Eyecare
Lilburn, GA 30047
Phone (770) 921-4707

Other identifiers

Identifier	Type	State	Issuer
410021154	Other		MEDICARE RAILROAD
202I418862	Other	GA	PTAN
GRP1065	Other	GA	GROUP PTAN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 12, 2015.

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1003892019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 A LAWRENCEVILLE HWY",
            "address_2": "LILBURN EYECARE",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "30047",
            "telephone_number": "770-921-4707",
            "fax_number": "770-925-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 A LAWRENCEVILLE HWY",
            "address_2": "LILBURN EYECARE",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "30047",
            "telephone_number": "770-921-4707",
            "fax_number": "770-925-8973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNETT",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "728T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410021154",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "202I418862",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "GRP1065",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

All providers in Lilburn, GA · Optometrist in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.