Individual provider Active NPI

John Steven Mason, OD

  • Optometrist
  • Kenansville, NC
National Provider Identifier
1174596472
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1767 Issued in NC
Practice address
304 N Main St
Duplin Eye Associates PA
Kenansville, NC 28349
Phone
(910) 296-1781
Fax
(910) 296-1843
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1767 NC Primary

Addresses

Primary practice location

304 N Main St
Duplin Eye Associates PA
Kenansville, NC 28349

Mailing address

PO Box 486
Kenansville, NC 28349-0486
Phone (910) 296-1781

Other identifiers 1

IdentifierTypeStateIssuer
890925XMedicaidNC

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
I20040621001594 NC Practitioner - Optometry 4587649850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duplin Eye Associates PAGroup PAC ID 1355325408, 2 clinicians

Practice addresses (Care Compare)

402 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-1781

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1767NCMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Duplin Eye Associates PA Optometrist CurrentSince Jun 22, 1999 Accepting new patients
Patty Vision Center OD PA Optometrist Past Accepting new patients
Patty Vision Center OD PA Optometrist Past Accepting new patients

Locations

402 N Main St
Kenansville, NC 28349
Phone (910) 296-1781

Interoperability endpoints

  • Direct secure messaging: johnpa@duplineye.eyefinity-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1174596472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 486",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283490486",
            "telephone_number": "910-296-1781",
            "fax_number": "910-296-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N MAIN ST",
            "address_2": "DUPLIN EYE ASSOCIATES PA",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "28349",
            "telephone_number": "910-296-1781",
            "fax_number": "910-296-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "JOHN",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890925X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenansville, NC

Sources for this page

Verify at the official NPI Registry.