Individual provider Active NPI

Sean Winston Smolenyak, OD

  • Optometrist
  • Raleigh, NC
National Provider Identifier
1144275439
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC1838 Issued in NC
Practice address
8851 Ellstree LN
Suite 200
Raleigh, NC 27617-2045
Phone
(919) 282-1100
Fax
(919) 282-1119
NPI assigned
May 24, 2006
Last updated
Apr 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC1838 NC Primary

Addresses

Primary practice location

8851 Ellstree LN
Suite 200
Raleigh, NC 27617-2045

Mailing address

8851 Ellstree LN
Suite 200
Raleigh, NC 27617-2045
Phone (919) 282-1100

Other identifiers 1

IdentifierTypeStateIssuer
89093MFMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssmolenyak@kellyeyecenter.intellechartdirect.net

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
I20040803001057 NC Practitioner - Optometry 3577534619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albemarle Eye Center PLLCGroup PAC ID 4981696499, 7 clinicians

Practice addresses (Care Compare)

101 Mark Dr
Edenton, NC 27932-1778
Phone (252) 482-7471

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NC1838NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Albemarle Eye Center, PLLC CurrentSince Jun 15, 2021 Accepting new patients
Albemarle Eye Center, PLLC Optometrist CurrentSince Jun 15, 2021 Accepting new patients
Albemarle Eye Center, PLLC Optometrist Past Accepting new patients

Locations

101 Mark Dr
Edenton, NC 27932
Phone (252) 482-7471

1503 N Road St
Elizabeth Cty, NC 27909
Phone 25233554462237

3524 N Croatan Hwy
Kitty Hawk, NC 27949
Phone (252) 441-3163

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1144275439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8851 ELLSTREE LN",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276172045",
            "telephone_number": "919-282-1100",
            "fax_number": "919-282-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8851 ELLSTREE LN",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276172045",
            "telephone_number": "919-282-1100",
            "fax_number": "919-282-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLENYAK",
        "first_name": "SEAN",
        "middle_name": "WINSTON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093MF",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssmolenyak@kellyeyecenter.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "8851 Ellstree Ln",
            "address_2": "Suite 200",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276172045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.