Mumtaz F Bashir, O.D.
Individual provider Active NPI Optometrist · Suwanee, GA
NPI 1356437883 · NPPES record last updated Oct 12, 2021
Key facts
- NPI
- 1356437883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1909 (GA)
- Practice address
- 2014 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2625 - Phone
- (678) 649-2020
- Fax
- (678) 331-5117
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2014 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2625
Phone (678) 370-0610
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100831000587 | GA | Practitioner - Optometry | 2769374438 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| U&M Family Eyecare | Optometrist | Current |
Accepting new patients |
Locations
30983 Highway 441 S
Commerce, GA 30529
Phone (706) 335-7818
2014 Lawrenceville Suwanee Rd
Suwanee, GA 30024
Phone (678) 370-0610
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1909 | GA | Yes |
Addresses
Primary practice location
2014 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2625
Mailing address
2964 Silvermere Lane
Duluth, GA 30097
Phone (678) 439-1393
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000919982B | Medicaid | GA |
Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.