Individual provider Active NPI

Joel Craig Swaim, O.D.

  • Optometrist
  • Raleigh, NC
National Provider Identifier
1053320036
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0949 Issued in NC
Practice address
4325 Glenwood Ave
Raleigh, NC 27612-4532
Phone
(919) 782-4100
Fax
(919) 787-9573
NPI assigned
Aug 7, 2006
Last updated
Jul 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 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 0949 NC Primary

Addresses

Primary practice location

4325 Glenwood Ave
Raleigh, NC 27612-4532

Mailing address

4325 Glenwood Ave
Raleigh, NC 27612-4532
Phone (919) 782-4100

Other identifiers 2

IdentifierTypeStateIssuer
5908670MedicaidNC
09880OtherNCBCBSNC

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
I20050329000383 NC Practitioner - Optometry 9931155066 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1977
Medicare assignment
May accept Medicare assignment
Group practices
Wake Forest Optometry PAGroup PAC ID 8224084348, 2 clinicians

Practice addresses (Care Compare)

11724 Retail Dr
Wake Forest, NC 27587-7349
Phone (919) 562-5559

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0949NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecarecenter OD PA Optometrist Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cswaim@direct.eyecare-partners.com

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, 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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1053320036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 GLENWOOD AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124532",
            "telephone_number": "919-782-4100",
            "fax_number": "919-787-9573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 GLENWOOD AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124532",
            "telephone_number": "919-782-4100",
            "fax_number": "919-787-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIM",
        "first_name": "JOEL",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "0949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908670",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "09880",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.