Baley Petersen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1741 Issued in SC

Practice address

966 Houston Northcutt Blvd
Suite D
Mount Pleasant, SC 29464-3487

Phone

(843) 881-2492

NPI assigned

Sep 7, 2012

Last updated

Aug 7, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Optometry

Education

Southern College of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lowcountry Eye Care of Goose CreekGroup PAC ID 6002005535, 6 clinicians

Avondale Eye CareGroup PAC ID 8527133370, 6 clinicians

Lowcountry Eye Care of Cane Bay LLCGroup PAC ID 3779857412, 7 clinicians

Lowcountry Eye Care of Mt Pleasant LLCGroup PAC ID 4587907035, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Avondale Eye Care

  • Optometrist
  • Charleston, SC
  • NPI 1285807131
  Medicare reassignment Care Compare group NPD
• Lowcountry Eye Care of Cane Bay, LLC

  dba Lowcountry Eye Care

  • Optometrist
  • Summerville, SC
  • NPI 1700319282
  Medicare reassignment Care Compare group NPD
• Lowcountry Eye Care of Goose Creek

  • Optometrist
  • Goose Creek, SC
  • NPI 1336440668
  Medicare reassignment Care Compare group NPD
• Lowcountry Eye Care of Mt Pleasant, LLC

  dba Lowcountry Eye Care

  • Optometrist
  • Mount Pleasant, SC
  • NPI 1306314562
  Medicare reassignment Care Compare group NPD
• Island Eye Care

  • Optometrist
  • Daniel Island, SC
  • NPI 1467639369
  Medicare reassignment NPD
• Eye Care Associates of SC LLC

  • Optometrist
  • Chapin, SC
  • NPI 1679046569
  NPD
• F Mason Smith

  dba F. Mason Smith, O.D.

  • Optometrist
  • Mount Pleasant, SC
  • NPI 1477795722
  NPD (past)
• Primary Care Optometry

  • Eyewear Supplier
  • Mount Pleasant, SC
  • NPI 1841597408
  NPD (past)

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1043569858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 CENTER STREET EXT APT 1001",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294644674",
            "telephone_number": "712-229-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 HOUSTON NORTHCUTT BLVD",
            "address_2": "SUITE D",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643487",
            "telephone_number": "843-881-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "BALEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-07",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Perseghin, D.C.
• Mia Persico
• Personal Performance
• Alison Pesavento, PHARMD
• Elisabeth Alice Peters, LPC
• Andrea Michelle Peterson, M.D.
• Ann M. Peterson, APRN-BC
• Tricia Peterson, DPT
• Alyssa Petry, WHNP-BC
• Christina Brueckner Pettit, PHARMD

• Optometrist in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.