Individual provider Active NPI

Sandra Nassar, OD

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1154843365
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2582 Issued in NC
Practice address
6035 Fairview Rd
Charlotte, NC 28210-3256
Phone
(704) 295-3000
NPI assigned
Jul 10, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sandra Nassar OD PLLC 3 clinicians

Practice addresses (Care Compare)

392 Talbert Rd
Mooresville, NC 28117-8034
Phone (980) 447-9764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 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
I20181017002464 SC Practitioner - Optometry 5294087318 Reassigns benefits to 1 organization
I20191022000153 NC Practitioner - Optometry 5294087318 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2582NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan Leblanc OD PLLC Optometrist CurrentSince Jan 1, 2021 Accepting new patients
Sandra Nassar OD PLLC Optometrist CurrentSince Mar 16, 2021 Accepting new patients

Locations

8180 S Tryon St
Charlotte, NC 28273
Phone (704) 588-9219

500 Tyvola Rd
Charlotte, NC 28217
Phone (704) 501-2402

7735 N Tryon St
Charlotte, NC 28262
Phone (704) 547-0305

392 Talbert Rd
Mooresville, NC 28117
Phone (980) 447-9750

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2582 NC Primary

Addresses

NPPES NPI Registry

Primary practice location

6035 Fairview Rd
Charlotte, NC 28210-3256

Mailing address

2506 McClintock Rd Unit 105
Charlotte, NC 28205-5252
Phone (412) 889-7420

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 12, 2019.

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1154843365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 MCCLINTOCK RD UNIT 105",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282055252",
            "telephone_number": "412-889-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6035 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103256",
            "telephone_number": "704-295-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSAR",
        "first_name": "SANDRA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.