Individual provider Active NPI

Julie Wasack, OD

  • Optometrist
  • Charleston, SC
National Provider Identifier
1225924418
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2536 Issued in SC
Practice address
12 Farmfield Ave Ste C
Charleston, SC 29407-7755
Phone
(843) 763-2270
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2536 SC Primary

Addresses

Primary practice location

12 Farmfield Ave Ste C
Charleston, SC 29407-7755

Mailing address

392 Horizon CT
Hardeeville, SC 29927-1615

Other practice location 1

102 Greenland Dr
Goose Creek, SC 29445-5353
Phone (843) 797-1264

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251006000411 SC Practitioner - Optometry 8921504218 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lowcountry Eye Care of Goose CreekGroup PAC ID 6002005535, 6 clinicians
Avondale Eye CareGroup PAC ID 8527133370, 6 clinicians

Practice addresses (Care Compare)

102 Greenland Dr
Goose Creek, SC 29445-5353
Phone (843) 797-1264

12 Farmfield Ave
Suite C
Charleston, SC 29407-7755
Phone (843) 763-2270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2536SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Avondale Eye Care Optometrist CurrentSince Oct 9, 2025 Accepting new patients
Lowcountry Eye Care of Cane Bay, LLC Optometrist CurrentSince Jul 14, 2025 Accepting new patients
Lowcountry Eye Care of Goose Creek Optometrist CurrentSince Jul 14, 2025 Accepting new patients

Locations

12 Farmfield Ave
Ste C
Charleston, SC 29407
Phone (843) 763-2270

102 Greenland Dr
Goose Creek, SC 29445
Phone (843) 203-6551

174 Beauregard Rd
Summerville, SC 29486
Phone (843) 821-0261

1718 State Rd
Ste 8D
Summerville, SC 29486
Phone (843) 900-4050

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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1225924418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "392 HORIZON CT",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299271615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 FARMFIELD AVE STE C",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077755",
            "telephone_number": "843-763-2270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Greenland Dr",
            "address_purpose": "LOCATION",
            "city": "Goose Creek",
            "state": "SC",
            "postal_code": "294455353",
            "country_code": "US",
            "telephone_number": "843-797-1264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASACK",
        "first_name": "JULIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.