Individual provider Active NPI

Rena Melton Pate, O.D.

  • Optometrist
  • Lexington, KY
National Provider Identifier
1376589234
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1636DT Issued in KY
Practice address
4051 Nicholasville Rd
Lexington, KY 40503-4432
Phone
(859) 971-0589
Fax
(859) 971-0591
NPI assigned
Jun 21, 2006
Last updated
Mar 5, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1636DT KY Primary
Optometrist 152W00000X 6761TG TX

Addresses

Primary practice location

4051 Nicholasville Rd
Lexington, KY 40503-4432

Mailing address

4051 Nicholasville Rd
Lexington, KY 40503-4432
Phone (859) 971-0589

Other identifiers 2

IdentifierTypeStateIssuer
77001477MedicaidKY
000000368848OtherKYBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160809001942 NC Practitioner - Optometry 6204865108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Eye Center Doctors of Optometry PAGroup PAC ID 6901883362, 12 clinicians

Practice addresses (Care Compare)

302 Cross Creek Mall
Fayetteville, NC 28303-7242
Phone (910) 867-4466

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1636DTKYMDOptometrist
6761TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Center, Doctors of Optometry, P.a. Optometrist CurrentSince Jun 1, 2016 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

1107 Walnut St
Ste 100
Cary, NC 27511
Phone (919) 460-0155

6910 Fayetteville Rd
Ste 296
Durham, NC 27713
Phone (919) 361-9488

302 Cross CRK Mall
Fayetteville, NC 28303
Phone (910) 867-4466

4351 The Cir At North Hills St
Ste 107
Raleigh, NC 27609
Phone (919) 782-9091

3500 Oleander Dr
Ste R55
Wilmington, NC 28403

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1376589234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4051 NICHOLASVILLE RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405034432",
            "telephone_number": "859-971-0589",
            "fax_number": "859-971-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 NICHOLASVILLE RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405034432",
            "telephone_number": "859-971-0589",
            "fax_number": "859-971-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATE",
        "first_name": "RENA",
        "middle_name": "MELTON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1636DT",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6761TG",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77001477",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000368848",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.