Individual provider Active NPI

Samantha Kelly-Seltzer, O.D.

  • Optometrist
  • Savannah, GA
National Provider Identifier
1023070588
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001892 Issued in GA
Practice address
7203 Hodgson Memorial Dr Ste a
Savannah, GA 31406-1525
Phone
(912) 352-9356
Fax
(912) 352-9105
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 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 OPT001892 GA Primary

Addresses

Primary practice location

7203 Hodgson Memorial Dr Ste a
Savannah, GA 31406-1525

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other identifiers 1

IdentifierTypeStateIssuer
881256974AMedicaidGA

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
I20120118000508 GA Practitioner - Optometry 1153598008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians

Practice addresses (Care Compare)

594 S Columbia Ave
Suite 200
Rincon, GA 31326-9096
Phone (912) 926-0935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT001892GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Feb 5, 2014 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Feb 5, 2014 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Past Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Past Accepting new patients

Locations

2610 Dawson Rd
Albany, GA 31707
Phone (229) 435-6776

3440 Wrightsboro Rd
Augusta, GA 30909
Phone (706) 733-0020

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

217 Riverstone Dr
Canton, GA 30114
Phone (770) 345-5220

123 W Main St
#A
Cartersville, GA 30120
Phone (470) 888-2044

911 N 3rd Ave
Chatsworth, GA 30705
Phone (706) 695-4676

6490 Veterans Pkwy
Columbus, GA 31909
Phone (706) 653-6200

2032 Veterans Blvd
Ste A
Dublin, GA 31021
Phone (478) 272-3445

2003 Commerce Dr
Ste 40
Kingsland, GA 31548

875 Lawrenceville Suwanee Rd
Lawrenceville, GA 30043
Phone (770) 822-2199

503 Furys Ferry Rd
Martinez, GA 30907
Phone (706) 860-8899

2485 N Columbia St
Ste 118
Milledgeville, GA 31061
Phone (478) 452-6569

1601 Macon Rd
Perry, GA 31069
Phone (478) 218-0404

105 Grand Central Blvd
Ste 110
Pooler, GA 31322
Phone (912) 450-9200

594 S Columbia Ave
Ste 200
Rincon, GA 31326
Phone (912) 826-0935

7203 Hodgson Memorial Dr
Ste A
Savannah, GA 31406
Phone (912) 352-9356

1014 Northside Dr E
Statesboro, GA 30458
Phone (912) 764-9147

1000 Peachtree Industrial Blvd
Suwanee, GA 30024
Phone (770) 271-0611

15196 US Highway 19 S
Thomasville, GA 31757
Phone (229) 228-4770

198 S Houston Lake Rd
Ste B
Warner Robins, GA 31088
Phone (478) 971-1500

2209 Memorial Dr
Waycross, GA 31501
Phone (912) 285-2021

12924 Highway 92
Ste 100
Woodstock, GA 30188
Phone (678) 717-9121

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1023070588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7203 HODGSON MEMORIAL DR STE A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061525",
            "telephone_number": "912-352-9356",
            "fax_number": "912-352-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY-SELTZER",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "881256974A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.