Brian Colletto, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1202 Issued in SC

Practice address

356 Oakland Ave
Rock Hill, SC 29730-4064

Phone

(803) 980-3937

Fax

(803) 980-5353

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

University Alabama Birmingham - School of Optometry, 2001

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Brian Colletto OD, Inc

  • Optometrist
  • Rock Hill, SC
  • NPI 1356485346
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1225144124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 OAKLAND AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304064",
            "telephone_number": "803-980-3937",
            "fax_number": "803-980-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 OAKLAND AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304064",
            "telephone_number": "803-980-3937",
            "fax_number": "803-980-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETTO",
        "first_name": "BRIAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D12029",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Michelle Colebank, OTR/L
• Chakosha Lance Coleman, MSPAS, PA-C
• Deja Coleman
• Iola Coleman
• Tiffani Coleman
• Serenity Collier
• Jenny Collins Sr., HSC
• Maureen Collins, MHP
• Susan M Collins, D.M.D.
• Amaiya Colmon

• Optometrist in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.