Individual provider Active NPI

Joseph M Pitcavage, DOCTOR OF OPTOMETRY

  • Optometrist
  • Mount Pleasant, SC
National Provider Identifier
1336167279
Registry record updated Dec 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1374 Issued in SC
Practice address
730 Coleman Blvd
Mt Pleasant, SC 29464-4053
Phone
(843) 870-4073
Fax
(843) 471-2022
NPI assigned
Jul 18, 2006
Last updated
Dec 29, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 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 1374 SC Primary

Addresses

Primary practice location

730 Coleman Blvd
Mt Pleasant, SC 29464-4053

Mailing address

650 Pawley Rd
Mount Pleasant, SC 29464-3566
Phone (843) 870-4073

Other identifiers 1

IdentifierTypeStateIssuer
D13741MedicaidSC

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
I20060214000121 SC Practitioner - Optometry 5395750244 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lowcountry Eye Care of Goose CreekGroup PAC ID 6002005535, 6 clinicians
Lowcountry Eye Care of Mt Pleasant LLCGroup PAC ID 4587907035, 4 clinicians

Practice addresses (Care Compare)

102 Greenland Dr
Goose Creek, SC 29445-5353
Phone (843) 797-1264

855 Houston Northcutt Blvd
Mt Pleasant, SC 29464-3446
Phone 80096936661431

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avondale Eye Care Optometrist CurrentSince Apr 1, 2008 Accepting new patients
Lowcountry Eye Care of Goose Creek Optometrist CurrentSince Dec 1, 2010 Accepting new patients
Lowcountry Eye Care of Cane Bay, LLC Optometrist CurrentSince Aug 1, 2017 Accepting new patients
Coastal Eye Care of Charleston, LLC Optometrist Past Accepting new patients
Bella Eye Care Inc. Optometrist Past Accepting new patients
Coastal Eye Care of James Island Optometrist PastSince Jan 1, 2017 Accepting new patients
Coastal Eye Care of Daniel Island Optometrist PastSince Jun 1, 2006 Accepting new patients
Primary Care Optometry PastSince Aug 27, 2019 Accepting new patients

Locations

12 Farmfield Ave
Ste C
Charleston, SC 29407
Phone (843) 763-2270

102 Greenland Dr
Goose Creek, SC 29445
Phone (843) 797-1264

1718 State Rd
Ste 8D
Summerville, SC 29486
Phone (843) 797-1264

174 Beauregard Rd
Summerville, SC 29486
Phone (843) 821-0261

Organizations & group practices 10

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514505600000",
    "number": "1336167279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 PAWLEY RD",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643566",
            "telephone_number": "843-870-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 COLEMAN BLVD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294644053",
            "telephone_number": "843-870-4073",
            "fax_number": "843-471-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITCAVAGE",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DOCTOR OF OPTOMETRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D13741",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.