Organization Active NPI

Palmetto Cataract and Eye Specialists, LLC

  • Ophthalmology Physician
  • Summerville, SC
National Provider Identifier
1114280526
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PALMETTO CATARACT AND EYE SPECIALISTS, LLC
Practice address
515 Carnes Crossing Blvd
Suite C
Summerville, SC 29486
Phone
(843) 259-2002
Fax
(843) 259-2005
NPI assigned
Jun 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Prat Itharat, MDNPI 1124281688
Title
Owner
Phone
(843) 259-2002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

515 Carnes Crossing Blvd
Suite C
Summerville, SC 29486

Mailing address

515 Carnes Crossing Blvd Ste C
Summerville, SC 29486-0412
Phone (843) 259-2002

Other identifiers 1

IdentifierTypeStateIssuer
31320OtherSCSTATE LICENSE

Other names 1

  • Palmetto Eye Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120815000562 SC Part B Supplier - Clinic/Group Practice 5193971612 Receives reassigned benefits from 1 practitioner
Practice locations: Summerville, SC

National Provider Directory

National Provider Directory

Locations

1516 Old Trolley Rd
Summerville, SC 29485
Phone (843) 820-3410

515 Carnes Crossing Blvd
Summerville, SC 29486

515 Carnes Crossing Blvd
Ste C
Summerville, SC 29486
Phone (843) 259-2002

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1114280526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 CARNES CROSSING BLVD STE C",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294860412",
            "telephone_number": "843-259-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 CARNES CROSSING BLVD",
            "address_2": "SUITE C",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29486",
            "telephone_number": "843-259-2002",
            "fax_number": "843-259-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO CATARACT AND EYE SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2023-03-07",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "ITHARAT",
        "authorized_official_first_name": "PRAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-259-2002",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "31320",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmetto Eye Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.