Individual provider Active NPI

Albert Lee Lundquist, PHYSICIAN ASSISTANT

  • Ophthalmology Physician
  • Greensboro, NC
National Provider Identifier
1295727634
Registry record updated Feb 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
100986 Issued in NC
Practice address
3312 Battleground Ave
Greensboro, NC 27410-2402
Phone
(336) 282-5000
Fax
(336) 545-9792
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 100986 NC Primary
Ophthalmology Physician 207W00000X 0110840384 VA

Addresses

Primary practice location

3312 Battleground Ave
Greensboro, NC 27410-2402

Mailing address

PO Box 38157
Greensboro, NC 27438-8157
Phone (336) 282-5000

Other identifiers 1

IdentifierTypeStateIssuer
561783008OtherNCTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041019001229 NC Practitioner - Physician Assistant 5193786671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Groat Eyecare Associates, P.a.Group PAC ID 3971507559, 4 clinicians

Practice addresses (Care Compare)

1317 N Elm St
Suite 4
Greensboro, NC 27401-1023
Phone (336) 378-1442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110840384VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Cataract Laser Center Ophthalmology Past Accepting new patients
Central Carolina Surgical Eye Associates, P.a. Ophthalmology Past Accepting new patients

Organizations & group practices 3

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296777600000",
    "number": "1295727634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38157",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274388157",
            "telephone_number": "336-282-5000",
            "fax_number": "336-545-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 BATTLEGROUND AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102402",
            "telephone_number": "336-282-5000",
            "fax_number": "336-545-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDQUIST",
        "first_name": "ALBERT",
        "middle_name": "LEE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2011-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "100986",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0110840384",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "561783008",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.