Individual provider Active NPI

Sanjay Bipin Patel, O.D.

  • Optometrist
  • Apex, NC
National Provider Identifier
1093763211
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1963 Issued in NC
Practice address
800 W. Williams Street, Suite 164
Apex, NC 27513
Phone
(919) 362-0332
Fax
(919) 362-0933
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 1963 NC
Optometrist 152W00000X 1963 NC Primary

Addresses

Primary practice location

800 W. Williams Street, Suite 164
Apex, NC 27513

Mailing address

1950 Old Gallows Rd
Suite 520
Vienna, VA 22182-3990
Phone (703) 847-8899

Other identifiers 2

IdentifierTypeStateIssuer
093T3OtherNCBCBS OF NC
5902150MedicaidNC

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
I20051021000047 NC Practitioner - Optometry 5496749228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of North Carolina PLLCGroup PAC ID 6608019096, 167 clinicians

Practice addresses (Care Compare)

1960 Randolph Rd
Charlotte, NC 28207-1129
Phone (704) 372-5332

800 W Williams St
Suite 164
Apex, NC 27502-5204
Phone (919) 362-0332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1963NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jun 21, 2014 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jun 21, 2014 Accepting new patients
Myeyedr Optometry of North Carolina Optometrist Past Accepting new patients

Locations

800 W Williams St
Ste 164
Apex, NC 27502
Phone (919) 362-0332

1975 High House Rd
Cary, NC 27519
Phone (919) 461-0771

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

326 Glensford Dr
Ste 108
Fayetteville, NC 28314
Phone (910) 864-6070

3603 Davis Dr
Ste 100
Morrisville, NC 27560
Phone (919) 234-4888

3214 Charles B Root Wynd
Ste 120
Raleigh, NC 27612
Phone (919) 881-0900

8231 Brier Creek Pkwy
Raleigh, NC 27617
Phone (919) 863-5032

6566 Glenwood Ave
Raleigh, NC 27612
Phone (919) 783-0011

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 4

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1093763211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "SUITE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W. WILLIAMS STREET, SUITE 164",
            "city": "APEX",
            "state": "NC",
            "postal_code": "27513",
            "telephone_number": "919-362-0332",
            "fax_number": "919-362-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SANJAY",
        "middle_name": "BIPIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": "1963",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "093T3",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902150",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

Verify at the official NPI Registry.