Samia Idris, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001870 Issued in GA

Practice address

2100 Pleasant Hill Rd
H10-1
Duluth, GA 30096-4701

Phone

(678) 475-0500

Fax

(678) 475-0563

NPI assigned

Jul 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• 2020 Eye Care

  • Optometrist
  • Alpharetta, GA
  • NPI 1124232228
  Medicare reassignment Authorized official
• Mark Lynn O.D. & Associates, PC

  dba Visionworks

  • Eyewear Supplier
  • Savannah, GA
  • NPI 1518375500
  NPD (past)
• Mark Lynn OD & Associates, PC

  dba Visionworks

  • Optometrist
  • Lithonia, GA
  • NPI 1417055203
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235164377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6663",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PLEASANT HILL RD",
            "address_2": "H10-1",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964701",
            "telephone_number": "678-475-0500",
            "fax_number": "678-475-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDRIS",
        "first_name": "SAMIA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Marie Hydes, APRN, FNP-BC
• Anne Elizabeth Hysong, APRN, CCNS, ACNS-BC
• Hyungwon Kang (Corner Pharmacy)
• I Care Home Service, LLC
• I Used Too Inc (Anytime Meals)
• Ann O. Igbre, M.D.
• Ihydrate LLC
• Im Elite LLC
• Phillip Im, CHIR 007185
• Anne Remondi Imhoff, PH.D.

• Optometrist in Duluth, GA
• Providers in Duluth, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.