Individual provider Active NPI

Sean Pitale, O.D.

  • Optometrist
  • Matthews, NC
National Provider Identifier
1225289952
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1529 Issued in SC
Practice address
4101 Campus Ridge Rd
Matthews, NC 28105-5077
Phone
(704) 234-1930
Fax
(704) 234-1940
NPI assigned
Sep 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002130 PA
Optometrist 152W00000X 2166 NC
Optometrist 152W00000X 1529 SC Primary

Addresses

Primary practice location

4101 Campus Ridge Rd
Matthews, NC 28105-5077

Mailing address

4101 Campus Ridge Rd
Matthews, NC 28105-5077
Phone (704) 234-1930

Other identifiers 4

IdentifierTypeStateIssuer
5920824MedicaidNC
0381OtherMEDICARE GROUP NUMBER FOR EMPLOYEE DR
3063OtherSCMEDICARE GROUP NUMBER
D15295MedicaidSC

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
I20120816000449 NC Practitioner - Optometry 0042368391 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilmington Eye, P.a.Group PAC ID 8921034323, 29 clinicians

Practice addresses (Care Compare)

1729 New Hanover Medical Park Dr
Wilmington, NC 28403-5345
Phone (910) 763-3601

Merit-based Incentive Payment System (MIPS)

Final score
89.61 of 100Reported as group
Quality
91.39
Promoting interoperability
100
Improvement activities
40
Cost
73.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG002130PAMDOptometrist
2166NCMDPhysical Therapist
1529SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Eye Care Associates, OD, PLLC Optometrist CurrentSince Aug 3, 2022 Accepting new patients
Wilmington Eye, P.a. CurrentSince Jul 8, 2024 Accepting new patients
Wilmington Eye, P.a. CurrentSince Jul 8, 2024 Accepting new patients
Dr. Michael a. Campbell Past Accepting new patients
Optical Solutions Past Accepting new patients

Locations

8811 Blakeney Professional Dr
Ste 100
Charlotte, NC 28277
Phone (704) 926-3937

5955 Weddington Rd
Ste 102
Wesley Chapel, NC 28104
Phone (704) 926-3937

9020 Senca Dr
Wilmington, NC 28411
Phone (901) 264-9317

1729 Medical Park
#P
Wilmington, NC 28403

1729 New Hanover Medical Park Dr
Wilmington, NC 28403
Phone (910) 772-8261

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: spitale@wileye.intellechartdirect.net

Organizations & group practices 5

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": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1225289952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 CAMPUS RIDGE RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055077",
            "telephone_number": "704-234-1930",
            "fax_number": "704-234-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 CAMPUS RIDGE RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055077",
            "telephone_number": "704-234-1930",
            "fax_number": "704-234-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITALE",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002130",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2166",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920824",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER FOR EMPLOYEE DR",
            "identifier": "0381",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "3063",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D15295",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.