Individual provider Active NPI

Tina Charlette Lucas-Glass, M.D.

  • Ophthalmology Physician
  • Marietta, GA
National Provider Identifier
1336232750
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
045285 Issued in GA
Practice address
61 Whitcher St NE Ste 4120
Marietta, GA 30060-1179
Phone
(470) 267-2980
Fax
(470) 986-7275
NPI assigned
Sep 30, 2006
Last updated
Apr 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 045285 GA Primary

Addresses

Primary practice location

61 Whitcher St NE Ste 4120
Marietta, GA 30060-1179

Mailing address

61 Whitcher St NE Ste 4120
Marietta, GA 30060-1179
Phone (470) 267-2980

Other practice location 1

3969 S Cobb Dr SE
Suite 105
Smyrna, GA 30080-6358
Phone (770) 434-9324

Other identifiers 1

IdentifierTypeStateIssuer
000802348EMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tlucasglass614874@directwellstar.org

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050914001053 GA Practitioner - Ophthalmology 7113950742 Reassigns benefits to 1 organization
Practice locations: Smyrna, GA

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Morehouse School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

61 Whitcher N E St
Suite 4120
Marietta, GA 30060-1179
Phone (770) 424-9732

61 Whitcher St NE
Suite 2100
Marietta, GA 30060-1179
Phone (770) 423-0595

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
045285GAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

61 Whitcher St NE
Ste 4120
Marietta, GA 30060

Interoperability endpoints

  • Direct secure messaging: direct@alphaeyeassociatesllcsmyrnaga.compulinkdirect.com
  • Direct secure messaging: tlucasglass614874@directwellstar.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1336232750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE STE 4120",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601179",
            "telephone_number": "470-267-2980",
            "fax_number": "470-986-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE STE 4120",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601179",
            "telephone_number": "470-267-2980",
            "fax_number": "470-986-7275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3969 S Cobb Dr SE",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "300806358",
            "country_code": "US",
            "telephone_number": "770-434-9324",
            "fax_number": "770-434-9364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAS-GLASS",
        "first_name": "TINA",
        "middle_name": "CHARLETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-30",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "045285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000802348E",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlucasglass614874@directwellstar.org",
            "affiliation": "N",
            "address_1": "61 Whitcher St NE Ste 4120",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.