Individual provider Active NPI

Eileen M Weitzel, OD

  • Optometrist
  • Greenville, NC
National Provider Identifier
1063465300
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1379 Issued in NC
Practice address
116 Regency Blvd
Greenville, NC 27834-4644
Phone
(252) 754-2020
Fax
(252) 493-0100
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1379 NC Primary

Addresses

Primary practice location

116 Regency Blvd
Greenville, NC 27834-4644

Mailing address

3740 S Memorial Dr
Suite a
Greenville, NC 27834-6700
Phone (252) 754-2020

Other identifiers 4

IdentifierTypeStateIssuer
85921OtherNCMEDCOST PIN
0915FOtherNCBCBS OF NC
562118060OtherNCTRICARE PIN
890915FMedicaidNC

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
I20071029000704 NC Practitioner - Optometry 4284535022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weitzel and Associates PAGroup PAC ID 8729989553, 4 clinicians

Practice addresses (Care Compare)

116 Regency Blvd
Greenville, NC 27834-4644
Phone (252) 754-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1379NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Weitzel & Associates PA Optometrist CurrentSince Jan 25, 1999 Accepting new patients

Locations

621 N Berkeley Blvd
Ste D
Goldsboro, NC 27534
Phone (919) 778-2023

116 Regency Blvd
Greenville, NC 27834
Phone (252) 754-2020

3740 S Memorial Dr
Ste A
Greenville, NC 27834
Phone (252) 754-2020

1212 Brown St
Washington, NC 27889
Phone (252) 501-0403

Organizations & group practices 1

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1063465300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 S MEMORIAL DR",
            "address_2": "SUITE A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278346700",
            "telephone_number": "252-754-2020",
            "fax_number": "252-493-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 REGENCY BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344644",
            "telephone_number": "252-754-2020",
            "fax_number": "252-493-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITZEL",
        "first_name": "EILEEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST PIN",
            "identifier": "85921",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "0915F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PIN",
            "identifier": "562118060",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890915F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.