Individual provider Active NPI

Elton Angoni, OD, MS

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1124755723
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003459 Issued in GA
Practice address
800 Mount Vernon Hwy NE Ste 130
Atlanta, GA 30328-4293
Phone
(404) 256-1125
NPI assigned
Aug 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003459 GA Primary

Addresses

Primary practice location

800 Mount Vernon Hwy NE Ste 130
Atlanta, GA 30328-4293

Mailing address

800 Mount Vernon Hwy NE Ste 130
Atlanta, GA 30328-4293
Phone (404) 256-1125

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
I20251201000083 GA Practitioner - Optometry 3779076682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

105 San Marino CT
Fayetteville, GA 30214-1435

PO Box
Fayetteville, GA 30214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OPT003459GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
A Plus Optique Optometrist CurrentSince Sep 22, 2025 Accepting new patients

Locations

1240 Highway 54 W
Ste 307
Fayetteville, GA 30214
Phone (678) 834-7411

Organizations & group practices 1

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": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1124755723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MOUNT VERNON HWY NE STE 130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284293",
            "telephone_number": "404-256-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MOUNT VERNON HWY NE STE 130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284293",
            "telephone_number": "404-256-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGONI",
        "first_name": "ELTON",
        "name_prefix": "Dr.",
        "credential": "OD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.