Individual provider Active NPI

Tonya Babjak Castro, OD

  • Optometrist
  • Mount Pleasant, SC
National Provider Identifier
1255413902
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1675 Issued in SC
Practice address
574 Lone Tree Dr
Mount Pleasant, SC 29464-8170
Phone
(843) 856-5275
Fax
(843) 856-8953
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1675 SC Primary

Addresses

Primary practice location

574 Lone Tree Dr
Mount Pleasant, SC 29464-8170

Mailing address

574 Lone Tree Dr
Mount Pleasant, SC 29464-8170
Phone (843) 856-5275

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
I20121203000487 SC Practitioner - Optometry 9830151323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1675SCMDDental Hygienist
006774NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office Past Accepting new patients

Organizations & group practices 1

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1255413902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "574 LONE TREE DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294648170",
            "telephone_number": "843-856-5275",
            "fax_number": "843-856-8953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "574 LONE TREE DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294648170",
            "telephone_number": "843-856-5275",
            "fax_number": "843-856-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "TONYA",
        "middle_name": "BABJAK",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.