Eye Specialists of Carolina, P.a.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

9800513 Issued in NC

Legal business name

EYE SPECIALISTS OF CAROLINA, P.A.

Practice address

3701 NW Cary Pkwy
Suite 101
Cary, NC 27513-8431

Phone

(919) 467-9955

NPI assigned

May 19, 2007

Organization subpart

No

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

Authorized official

Name

Demetrian I. Dornic, M.D.NPI 1881740090

Title

President

Phone

(919) 467-9955

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Laser Eye Center of Carolina Other name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Demetrian Ivan Dornic, M.D.

  • Ophthalmology Physician
  • Cary, NC
  • NPI 1881740090
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255549424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 NW CARY PKWY",
            "address_2": "SUITE 101",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138431",
            "telephone_number": "919-467-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 NW CARY PKWY",
            "address_2": "SUITE 101",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138431",
            "telephone_number": "919-467-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SPECIALISTS OF CAROLINA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DORNIC",
        "authorized_official_first_name": "DEMETRIAN",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-467-9955",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "9800513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891183H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89128E2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laser Eye Center of Carolina",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Ophthalmology Physician in Cary, NC
• Providers in Cary, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.