Individual provider Active NPI

Michael Z Morabito, OD

  • Optometrist
  • Charleston, SC
National Provider Identifier
1265495220
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1261 Issued in SC
Practice address
88 Folly Road Blvd
Charleston, SC 29407-7551
Phone
(843) 573-9944
Fax
(843) 573-9969
NPI assigned
Apr 10, 2006
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1261 SC Primary

Addresses

Primary practice location

88 Folly Road Blvd
Charleston, SC 29407-7551

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970

Other identifiers 6

IdentifierTypeStateIssuer
D12617MedicaidSC
200828972OtherSCBLUE CROSS BLUE SHEILD
E1473OtherSCMEDCOST
U952847884OtherSCINSTILL HEALTH INSURANCE
1261OtherSCSTATE OPTOMETRY LICENSE NUMBER
922OtherSCBLUE CHOICE HEALTH PLAN

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
I20040419000745 SC Practitioner - Optometry 9830184803 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1261SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of South Carolina, LLC Optometrist CurrentSince Oct 25, 2021 Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist CurrentSince Oct 25, 2021 Accepting new patients
Vision Care Resources LLC Optometrist Current Accepting new patients
Draisin Vision Group PA Optometrist Past Accepting new patients
LTC Eyecare Inc Optometrist PastSince Jul 19, 2010 Accepting new patients

Locations

3050 Ashley Town Center Dr
Charleston, SC 29414
Phone (843) 460-2001

88 Folly Road Blvd
Charleston, SC 29407
Phone (843) 573-9944

1268 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 327-2001

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1265495220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 FOLLY ROAD BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077551",
            "telephone_number": "843-573-9944",
            "fax_number": "843-573-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORABITO",
        "first_name": "MICHAEL",
        "middle_name": "Z",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D12617",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "200828972",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "E1473",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTILL HEALTH INSURANCE",
            "identifier": "U952847884",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OPTOMETRY LICENSE NUMBER",
            "identifier": "1261",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE HEALTH PLAN",
            "identifier": "922",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.