Individual provider Active NPI

Alexis Yu

  • Optometrist
  • Duluth, GA
National Provider Identifier
1013667427
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003401 Issued in GA
Practice address
2635 Pleasant Hill Rd
Duluth, GA 30096-1471
Phone
(770) 476-2164
NPI assigned
Mar 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003401 GA Primary

Addresses

Primary practice location

2635 Pleasant Hill Rd
Duluth, GA 30096-1471

Mailing address

2635 Pleasant Hill Rd
Duluth, GA 30096-1471
Phone (770) 476-2164

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL alexisyu416@gmail.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230918002840 GA Practitioner - Optometry 3375907793 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003401GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Sep 5, 2023 Accepting new patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Sep 5, 2023 Accepting new patients

Locations

50 Main Street Market Pl SE
Ste 100
Cartersville, GA 30121
Phone (770) 382-6379

Networks

  • FL HMO C-SNP
  • FL HMO

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1013667427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 PLEASANT HILL RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961471",
            "telephone_number": "770-476-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 PLEASANT HILL RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961471",
            "telephone_number": "770-476-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "alexisyu416@gmail.com",
            "affiliation": "N",
            "endpointDescription": "alexisyu416@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9540 Kingston Crossing Cir",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300225598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.