Individual provider Active NPI

Paul M Salvatore, O.D.

  • Optometrist
  • Mt Pleasant, SC
National Provider Identifier
1124113162
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1935 Issued in SC
Practice address
709 Long Point Rd Ste C
Mt Pleasant, SC 29464-8287
Phone
(843) 849-0800
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X R-339 AL
Optometrist 152W00000X OPT003370 GA
Optometrist 152W00000X 1935 SC Primary

Addresses

Primary practice location

709 Long Point Rd Ste C
Mt Pleasant, SC 29464-8287

Mailing address

105 Brandt Dr.
Suite 201
Cranberry TWP., PA 16066-6412
Phone (724) 772-5420

Other practice location 1

105 Brandt Dr.
Suite 201
Cranberry Twp., PA 16066-6412
Phone (724) 772-5420

Other identifiers 2

IdentifierTypeStateIssuer
101446321MedicaidPA
1764972OtherPAHIGHMARK BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161220001792 SC Practitioner - Optometry 9830255306 Reassigns benefits to 1 organization
I20230815002381 GA Practitioner - Optometry 9830255306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians
Myeyedr Optometry of South Carolina, LLCGroup PAC ID 3173741618, 24 clinicians

Practice addresses (Care Compare)

4875 Altama Ave
Brunswick, GA 31520-2912
Phone (912) 554-0010

709 Long Point Rd
Suite C
Mt Pleasant, SC 29464-8287
Phone (843) 849-0800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R-339ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jul 9, 2023 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist CurrentSince Oct 20, 2016 Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jul 9, 2023 Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist CurrentSince Oct 20, 2016 Accepting new patients
Associates in Ophthalmology LTD Past Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist PastSince Sep 8, 2025 Accepting new patients

Locations

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

1409 Sixes Rd
Canton, GA 30114
Phone (770) 852-2733

3801 Northside Dr
Macon, GA 31210
Phone (478) 475-1600

1044 Avalon Pkwy
McDonough, GA 30253
Phone (770) 898-7078

105 Grand Central Blvd
Ste 110
Pooler, GA 31322
Phone (912) 450-9200

7203 Hodgson Memorial Dr
Ste A
Savannah, GA 31406
Phone (912) 352-9356

1000 Peachtree Industrial Blvd
Suwanee, GA 30024
Phone (770) 271-0611

1000 Peachtree Industrial Blvd
Ste 14
Suwanee, GA 30024
Phone (770) 271-0611

179 Handley Rd
Ste C
Tyrone, GA 30290
Phone (770) 486-1020

204 Midtown Dr
Beaufort, SC 29906
Phone (843) 521-0138

1826 Highway 160 W
Ste 101
Fort Mill, SC 29708
Phone (803) 650-3080

210 Mills Ave
Greenville, SC 29605
Phone (803) 232-2779

1617 Wade Hampton Blvd
Greenville, SC 29609
Phone (864) 322-9050

812 W Wade Hampton Blvd
Greer, SC 29650
Phone (864) 877-1825

1774 Paxville Hwy
Manning, SC 29102
Phone (803) 435-2494

709 Long Point Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 259-2002

7643 Rivers Ave
Ste D
North Charleston, SC 29406
Phone (843) 797-0731

306 E Main St
Pickens, SC 29671
Phone (864) 638-9505

1268 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 327-2001

622 Bacons Bridge Rd
Ste B
Summerville, SC 29485
Phone (843) 594-0919

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 8

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1124113162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BRANDT DR.",
            "address_2": "SUITE 201",
            "city": "CRANBERRY TWP.",
            "state": "PA",
            "postal_code": "160666412",
            "telephone_number": "724-772-5420",
            "fax_number": "724-772-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 LONG POINT RD STE C",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648287",
            "telephone_number": "843-849-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Brandt Dr.",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Cranberry Twp.",
            "state": "PA",
            "postal_code": "160666412",
            "country_code": "US",
            "telephone_number": "724-772-5420",
            "fax_number": "724-772-5423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALVATORE",
        "first_name": "PAUL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "R-339",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003370",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101446321",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "1764972",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

Verify at the official NPI Registry.