Individual provider Active NPI

Purvi Patel, OD

  • Optometrist
  • Woodstock, GA
National Provider Identifier
1306376942
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003134 Issued in GA
Practice address
12924 Highway 92
Woodstock, GA 30188-5192
Phone
(678) 717-9121
Fax
(770) 926-2287
NPI assigned
Jun 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003134 GA Primary

Addresses

Primary practice location

12924 Highway 92
Woodstock, GA 30188-5192

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200608002958 GA Practitioner - Optometry 7810318326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians

Practice addresses (Care Compare)

12924 Hwy 92
Suite 100
Woodstock, GA 30188-5193
Phone (678) 717-9121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Mar 2, 2020 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Mar 2, 2020 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist PastSince Feb 27, 2022 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist PastSince Feb 27, 2022 Accepting new patients

Locations

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

217 Riverstone Dr
Canton, GA 30114
Phone (770) 345-5220

9801 Highway 92
Ste 100
Woodstock, GA 30188
Phone (770) 592-7100

12924 Highway 92
Ste 100
Woodstock, GA 30188
Phone (678) 717-9121

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 5

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1306376942",
    "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": "12924 HIGHWAY 92",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301885192",
            "telephone_number": "678-717-9121",
            "fax_number": "770-926-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PURVI",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.