Nicole Marie Pecko, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2002 Issued in SC

Practice address

19 Promenade St
Bluffton, SC 29910-7037

Phone

(843) 815-4343

NPI assigned

Jun 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nicole Marie Maciag Former name

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Catherine Ann Darling, O.D.

  • Optometrist
  • Hilton Head Island, SC
  • NPI 1952461931

  SC

  Medicare reassignment
• Carolina Eyecare Physicians LLC

  • Ophthalmology Physician
  • N Charleston, SC
  • NPI 1659421238
  NPD (past)
• Coastal Grand Eye Associates LTD. Co.

  • Optometrist
  • Myrtle Beach, SC
  • NPI 1780728824
  NPD (past)
• Darling Eye Center

  • Optometrist
  • Bluffton, SC
  • NPI 1780855486
  NPD (past)

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1154851376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MULBERRY GROVE LN",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299107987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 PROMENADE ST",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299107037",
            "telephone_number": "843-815-4343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Columbiana Cir",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292122231",
            "country_code": "US",
            "telephone_number": "803-781-1669",
            "fax_number": "803-781-2582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "470 Town Center Pl Ste 5",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292297957",
            "country_code": "US",
            "telephone_number": "803-865-3901",
            "fax_number": "803-865-1451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECKO",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D20029",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MACIAG",
            "middle_name": "MARIE",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taylor Paul, D.C.
• Kelsey Elizabeth Pauley, DPT
• Madison Pawley
• Peace of Mind in Home Care
• Ellen R Pearson, P.T.A.
• Alexia Pecoraro, DPT, PT
• Michael Kennedy Pecosh, M.ED., NCC, LPC
• Pediatric Smiles, LLC
• Michela Pelizario Dennis
• Misty Marie Penrod, APRN

• All providers in Bluffton, SC
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.