Individual provider Active NPI

Cari Lynn Moore, OD

  • Optometrist
  • Aiken, SC
National Provider Identifier
1265572085
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2202 Issued in SC
Practice address
3521 Richland Ave
Aiken, SC 29801-6311
Phone
(803) 641-4646
Fax
(803) 641-4648
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10138T CA
Optometrist 152W00000X OPT003292 GA
Optometrist 152W00000X 2202 SC Primary

Addresses

Primary practice location

3521 Richland Ave
Aiken, SC 29801-6311

Mailing address

217 E Lake Ave
Watsonville, CA 95076-4716
Phone (831) 724-3823

Other practice location 1

1055 Silver Bluff Rd Ste A
Aiken, SC 29803-5884
Phone (803) 642-4339

Other practice location 2

11H Robert Smalls Pkwy # H
Beaufort, SC 29906-4200
Phone (843) 524-8302

Other practice location 3

3152 Washington Rd
Augusta, GA 30907-3834
Phone (334) 520-2161

Other identifiers 3

IdentifierTypeStateIssuer
5679634MedicaidCA
BO427AOtherCAPTAN
2202OtherSCSC STATE LICENSE

Other names 1

  • Dr. Cari Lynn Londal Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210225002653 GA Practitioner - Optometry 9931195070 Reassigns benefits to 2 organizations
I20210610000360 SC Practitioner - Optometry 9931195070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
S and H Eye Care, LLCGroup PAC ID 3072770932, shared by 2 NPIs, 6 clinicians

Practice addresses (Care Compare)

3152 Washington Rd
Augusta, GA 30907-3834
Phone (706) 651-1291

3521 Richland Ave W
Aiken, SC 29801-6311
Phone (803) 641-4646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10138TCAMDOptometrist
OPT003292GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Krupa Tailor OD a Professional Corporation Optometrist CurrentSince Nov 1, 2020 Accepting new patients
S & H Eye Care, LLC Optometrist CurrentSince Jun 3, 2021 Accepting new patients
S & H Eye Care, LLC Optometrist CurrentSince Jun 3, 2021 Accepting new patients
S & H Eye Care, LLC Optometrist CurrentSince Jun 3, 2021 Accepting new patients
S & H Eye Care, LLC Optometrist Current Accepting new patients
Martinez Eye Associates LLC Optometrist CurrentSince Nov 25, 2020 Accepting new patients
Foot Clinic of Santa Cruz County, Inc Past Accepting new patients

Locations

217 E Lake Ave
Watsonville, CA 95076
Phone (408) 724-6410

3152 Washington Rd
Augusta, GA 30907
Phone (706) 651-1291

3412 Wrightsboro Rd
Ste 905
Augusta, GA 30909
Phone (706) 736-3937

1055 Silver Bluff Rd
Ste A
Aiken, SC 29803
Phone (803) 642-4339

3521 Richland Ave W
Aiken, SC 29801
Phone (803) 641-4646

11 Robert Smalls Pkwy
Ste H
Beaufort, SC 29906
Phone (843) 524-8302

Organizations & group practices 7

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1265572085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 E LAKE AVE",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950764716",
            "telephone_number": "831-724-3823",
            "fax_number": "831-724-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 RICHLAND AVE",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016311",
            "telephone_number": "803-641-4646",
            "fax_number": "803-641-4648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 Silver Bluff Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Aiken",
            "state": "SC",
            "postal_code": "298035884",
            "country_code": "US",
            "telephone_number": "803-642-4339",
            "fax_number": "803-649-6799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11H Robert Smalls Pkwy # H",
            "address_purpose": "LOCATION",
            "city": "Beaufort",
            "state": "SC",
            "postal_code": "299064200",
            "country_code": "US",
            "telephone_number": "843-524-8302",
            "fax_number": "843-379-5974",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3152 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309073834",
            "country_code": "US",
            "telephone_number": "334-520-2161",
            "fax_number": "706-210-8090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CARI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10138T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003292",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5679634",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "BO427A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC STATE LICENSE",
            "identifier": "2202",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARI",
            "last_name": "LONDAL",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.