Individual provider Active NPI

Scott T Emely, OD

  • Optometrist
  • Suwanee, GA
National Provider Identifier
1174716146
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2336 Issued in GA
Practice address
4330 Johns Creek Pkwy
Suite 300
Suwanee, GA 30024-6047
Phone
(770) 232-7844
Fax
(770) 232-9455
NPI assigned
Aug 23, 2007
Last updated
Mar 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 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 2336 GA Primary

Addresses

Primary practice location

4330 Johns Creek Pkwy
Suite 300
Suwanee, GA 30024-6047

Mailing address

4330 Johns Creek Pkwy
Suite 300
Suwanee, GA 30024-6047
Phone (770) 232-7844

Other identifiers 1

IdentifierTypeStateIssuer
511I410012OtherGAPTAN

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
I20071213000220 GA Practitioner - Optometry 9830289966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Payne and Payne PCGroup PAC ID 5597666545, 5 clinicians

Practice addresses (Care Compare)

4330 Johns Creek Pkwy
Suite 300
Suwanee, GA 30024-6121
Phone (770) 232-7844

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2336GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Oneopto Ga 1 PLLC Optometrist PastSince Aug 16, 2007 Accepting new patients

Organizations & group practices 2

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": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1174716146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 JOHNS CREEK PKWY",
            "address_2": "SUITE 300",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246047",
            "telephone_number": "770-232-7844",
            "fax_number": "770-232-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 JOHNS CREEK PKWY",
            "address_2": "SUITE 300",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246047",
            "telephone_number": "770-232-7844",
            "fax_number": "770-232-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMELY",
        "first_name": "SCOTT",
        "middle_name": "T",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "2336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "511I410012",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.