Northside Eye Partners, PC

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

Legal business name

NORTHSIDE EYE PARTNERS, PC

Doing business as

Marietta Vision Professionals

Practice address

2230 Roswell Rd
Suite 100
Marietta, GA 30062-2939

Phone

(678) 903-2579

Fax

(678) 903-2583

NPI assigned

Oct 24, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Paul Suji, O.D.NPI 1447457817

Title

President

Phone

(678) 903-2579

Specialties & licenses 1

Addresses

Other names 1

• Marietta Vision Professionals Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul I Suji, OD

  • Optometrist
  • Atlanta, GA
  • NPI 1447457817
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401321600000",
    "number": "1083042253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 ROSWELL RD",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622939",
            "telephone_number": "678-903-2579",
            "fax_number": "678-903-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 ROSWELL RD",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622939",
            "telephone_number": "678-903-2579",
            "fax_number": "678-903-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE EYE PARTNERS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2014-05-29",
        "status": "A",
        "authorized_official_last_name": "SUJI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-903-2579",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marietta Vision Professionals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Corneal and Contact Management Optometrist in Marietta, GA
• Providers in Marietta, GA by specialty
• Corneal and Contact Management Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.