Individual provider Active NPI

Phillip M Vito, OD

  • Optometrist
  • Holly Springs, NC
National Provider Identifier
1104826528
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC 1652 Issued in NC
Practice address
608 Holly Springs Rd
Holly Springs, NC 27540-9030
Phone
(919) 577-3937
Fax
(919) 577-9260
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC 1652 NC Primary
Optometrist 152W00000X 4872 NJ
Optometrist 152W00000X 6828 PA
Corneal and Contact Management Optometrist 152WC0802X 1652 NC
Low Vision Rehabilitation Optometrist 152WL0500X 1652 NC
Pediatric Optometrist 152WP0200X 1652 NC
Sports Vision Optometrist 152WS0006X 1652 NC
Occupational Vision Optometrist 152WX0102X 1652 NC

Addresses

Primary practice location

608 Holly Springs Rd
Holly Springs, NC 27540-9030

Mailing address

608 Holly Springs Rd
Holly Springs, NC 27540-9030
Phone (919) 577-3937

Other identifiers 1

IdentifierTypeStateIssuer
890905JMedicaidNC

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
I20040525001482 NC Practitioner - Optometry 1254312341 Reassigns benefits to 1 organization
Practice locations: Holly Springs, NC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Eye Care GroupGroup PAC ID 6002888559, 7 clinicians

Practice addresses (Care Compare)

4325 Glenwood Ave
Suite F
Raleigh, NC 27612-4532
Phone (919) 786-0141

608 Holly Springs Rd
Holly Springs, NC 27540-9030
Phone (919) 577-3937

Merit-based Incentive Payment System (MIPS)

Final score
7.5 of 100Reported as individual
Quality
15
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NC 1652NCMDOptometrist
4872NJMDOptometrist
6828PAMDOptometrist
1652NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Eye Care Group Optometrist CurrentSince Sep 1, 2020 Accepting new patients
Dr. Phillip M. Vito Optometrist PastSince Jan 1, 1990 Accepting new patients

Locations

642 Friendly Center Rd
Greensboro, NC 27408
Phone (336) 292-9007

330 Four Seasons Town Ctr
Greensboro, NC 27407
Phone (336) 854-1204

4441 Six Forks Rd
Ste 106
Raleigh, NC 27609
Phone (919) 434-9350

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

4325 Glenwood Ave
Ste F
Raleigh, NC 27612
Phone (919) 786-0141

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1104826528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 HOLLY SPRINGS RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409030",
            "telephone_number": "919-577-3937",
            "fax_number": "919-577-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 HOLLY SPRINGS RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409030",
            "telephone_number": "919-577-3937",
            "fax_number": "919-577-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITO",
        "first_name": "PHILLIP",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC 1652",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "4872",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "6828",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": "1652",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NC",
            "license": "1652",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NC",
            "license": "1652",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "NC",
            "license": "1652",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "NC",
            "license": "1652",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890905J",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

Verify at the official NPI Registry.