Individual provider Active NPI

Stephen T. Coss

  • Optometrist
  • Greenville, SC
National Provider Identifier
1316176142
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
949 Issued in SC
Practice address
1617 Wade Hampton Blvd.
Greenville, SC 29609
Phone
(864) 322-9050
Fax
(864) 322-9059
NPI assigned
Jul 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 949 SC Primary

Addresses

Primary practice location

1617 Wade Hampton Blvd.
Greenville, SC 29609

Mailing address

1950 Old Gallows Rd
Suite 520
Vienna, VA 22182-3990
Phone (703) 847-8899

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
I20151207000061 SC Practitioner - Optometry 7012217581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of South Carolina, LLCGroup PAC ID 3173741618, 24 clinicians

Practice addresses (Care Compare)

1617 Wade Hampton Blvd
Greenville, SC 29609-5049
Phone (864) 322-9050

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
949SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of South Carolina, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist CurrentSince Oct 17, 2015 Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist CurrentSince Oct 17, 2015 Accepting new patients

Locations

210 Mills Ave
Greenville, SC 29605
Phone (803) 232-2779

1617 Wade Hampton Blvd
Greenville, SC 29609
Phone (864) 322-9050

812 W Wade Hampton Blvd
Greer, SC 29650
Phone (864) 877-1825

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 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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1316176142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "SUITE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 WADE HAMPTON BLVD.",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29609",
            "telephone_number": "864-322-9050",
            "fax_number": "864-322-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSS",
        "first_name": "STEPHEN",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.