Individual provider Active NPI

Divya Bhakta, O.D.

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1164770541
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002708 Issued in GA
Practice address
860 Peachtree St NE Ste F
Atlanta, GA 30308-1288
Phone
(404) 853-5008
Fax
(404) 853-5009
NPI assigned
Aug 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002708 GA Primary

Addresses

Primary practice location

860 Peachtree St NE Ste F
Atlanta, GA 30308-1288

Mailing address

1950 Old Gallows Rd
Vienna, VA 22182-3990

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
I20130313000557 GA Practitioner - Optometry 0547405847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians

Practice addresses (Care Compare)

100 N Peachtree Pkwy
Suite 1
Peachtree City, GA 30269-1744
Phone (770) 487-8900

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002708GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jun 24, 2019 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jun 24, 2019 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Past Accepting new patients

Locations

860 Peachtree St NE
Ste F
Atlanta, GA 30308
Phone (404) 853-5008

800 Peachtree St NE
Ste E1
Atlanta, GA 30308
Phone (678) 732-3432

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

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

100 N Peachtree Pkwy
Ste 1
Peachtree Cty, GA 30269
Phone (770) 487-8900

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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.

NPI Registry JSON

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1164770541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 PEACHTREE ST NE STE F",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081288",
            "telephone_number": "404-853-5008",
            "fax_number": "404-853-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAKTA",
        "first_name": "DIVYA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "002708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.