Individual provider Active NPI

Puja Patel, O.D.

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1174936876
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002862 Issued in GA
Practice address
3330 Piedmont Rd NE
Suite 1
Atlanta, GA 30305-1726
Phone
(404) 231-3772
NPI assigned
Jun 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 21299-875 WI
Optometrist 152W00000X 046-010801 IL
Optometrist 152W00000X TPOP59 FL
Optometrist 152W00000X 3752-35 WI
Optometrist 152W00000X OPT002862 GA Primary

Addresses

Primary practice location

3330 Piedmont Rd NE
Suite 1
Atlanta, GA 30305-1726

Mailing address

2300 Whiteoak Dr SE
Smyrna, GA 30080-7422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 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
I20150821014737 GA Practitioner - Optometry 8921225640 Reassigns benefits to 4 organizations
I20210920000287 FL Practitioner - Optometry 8921225640 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TPOP59FLMDOptometrist
OPT002862GAMDOptometrist
046-010801ILMDOptometrist
21299-875WIMDOptometrist
3752-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Sep 8, 2021 Accepting new patients
Family First Vision Care Georgia Optometrist CurrentSince Apr 28, 2023 Accepting new patients
Mark Lynn O.D. & Associates, PC CurrentSince Jun 30, 2015 Accepting new patients
Myeyedr. Optometry of Florida, LLC Optometrist CurrentSince Sep 8, 2021 Accepting new patients
Mark Lynn OD & Associates, PC Optometrist CurrentSince Jun 30, 2015 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Feb 3, 2023 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia LLC Optometrist CurrentSince Feb 3, 2023 Accepting new patients
Chance Talley Enterprises LLC. CurrentSince May 11, 2023 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients

Locations

2140 Crawfordville Hwy
Crawfordville, FL 32327
Phone (850) 926-9213

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

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

2929 Turner Hill Rd
Ste 2625
Lithonia, GA 30038
Phone (770) 482-5050

1401 Johnson Ferry Rd
Ste 148B
Marietta, GA 30062
Phone (770) 509-8480

1850 N Columbia St
Ste 5
Milledgeville, GA 31061
Phone (478) 453-0011

198 S Houston Lake Rd
Ste B
Warner Robins, GA 31088
Phone (478) 971-1500

316 S Hamilton Rd
Gahanna, OH 43230

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 10

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1174936876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WHITEOAK DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300807422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 PIEDMONT RD NE",
            "address_2": "SUITE 1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051726",
            "telephone_number": "404-231-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PUJA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "21299-875",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-010801",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "TPOP59",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3752-35",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.