Individual provider Active NPI

Ria Patel

  • Optometrist
  • Kennesaw, GA
National Provider Identifier
1104665983
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003590 Issued in GA
Practice address
600 Chastain Rd NW Ste 312
Kennesaw, GA 30144-3047
Phone
(770) 428-8090
NPI assigned
May 22, 2024
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003590 GA Primary

Addresses

Primary practice location

600 Chastain Rd NW Ste 312
Kennesaw, GA 30144-3047

Mailing address

213 Arpeggio Way
Alpharetta, GA 30009-8009
Phone (678) 637-8646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20241002002856 GA Practitioner - Optometry 3577094457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas Eye Group PCGroup PAC ID 2567455868, 51 clinicians

Practice addresses (Care Compare)

600 Chastain Rd NW
Suite 312
Kennesaw, GA 30144-3047
Phone (770) 428-8090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003590GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Eye Group PC Optometrist CurrentSince Aug 5, 2024 Accepting new patients
Thomas Eye Group PC Optometrist Current Accepting new patients
Thomas Eye Group PC Optometrist CurrentSince Aug 5, 2024 Accepting new patients

Locations

600 Chastain Rd NW
Ste 312
Kennesaw, GA 30144
Phone (770) 428-8090

3960 Shallowford Rd
Ste A
Marietta, GA 30062
Phone (770) 642-4001

11690 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 475-5515

5901 Peachtree Dunwoody Rd
Ste 500
Sandy Springs, GA 30328
Phone (678) 781-7373

Interoperability endpoints

  • Direct secure messaging: rpatel@teg.emadirect.md

Organizations & group practices 3

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": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1104665983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 ARPEGGIO WAY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300098009",
            "telephone_number": "678-637-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CHASTAIN RD NW STE 312",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443047",
            "telephone_number": "770-428-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.