A Plus Optique
Organization Active NPI Optometrist · Fayetteville, GA
NPI 1235549536 · NPPES record last updated Jul 21, 2026
Key facts
- NPI
- 1235549536
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- LDO002220 (GA)
- Legal business name
- A PLUS OPTIQUE
- Practice address
- 1240 Highway 54 W Ste 307
Fayetteville, GA 30214-4563 - Phone
- (678) 834-7411
- Fax
- (678) 834-7432
- NPI assigned
- May 7, 2014
- Organization subpart
- No
Authorized official
- Name
- Crystal Wade, OD
- Title
- Optometrist
- Phone
- (678) 834-7411
Practitioners 2
-
Elton Angoni, OD, MS
-
Crystal Wade, LDO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251126001679 | GA | Part B Supplier - Clinic/Group Practice | 3375964752 |
Receives reassigned benefits from 1 practitioner Practice locations: Fayetteville, GA |
National Provider Directory
Locations
1240 Highway 54 W
Ste 306
Fayetteville, GA 30214
Phone (678) 834-7411
1240 Highway 54 W
Ste 307
Fayetteville, GA 30214
Phone (678) 834-7411
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | LDO002220 | GA | Yes |
Addresses
Primary practice location
1240 Highway 54 W Ste 307
Fayetteville, GA 30214-4563
Mailing address
PO Box 144085
Fayetteville, GA 30214-6543
Phone (678) 834-7411
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GA00314733A | Medicaid | GA |
Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.