Active NPI
Nickolas Andrew Vastis, O.D.
- Optometrist
- Columbia, SC
National Provider Identifier
1376647396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1423
- Practice address
- 350 Harbison Blvd
Columbia, SC 29212-2248 - Phone
- (803) 749-6878
- NPI assigned
- Sep 11, 2006
- Last updated
- Sep 11, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1423 | SC | Primary |
Addresses
Primary practice location
350 Harbison Blvd
Columbia, SC 29212-2248
Mailing address
627 Crestmont Rd
Columbia, SC 29229-7027
Phone (803) 699-5110
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1510 Onyx RDG
Suite 101
Fort Mill, SC 29708-8970
Phone (803) 802-3937
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optique | Optometrist | Current | Accepting new patients |
| East Coast Optometric, Inc | Optometrist | Past | Accepting new patients |
Locations
1510 Onyx Rdg
Ste 101
Fort Mill, SC 29708
Phone (803) 409-8332
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.
-
- Optometrist
- Fort Mill, SC
- NPI 1891048872
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347321600000",
"number": "1376647396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "627 CRESTMONT RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292297027",
"telephone_number": "803-699-5110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 HARBISON BLVD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292122248",
"telephone_number": "803-749-6878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASTIS",
"first_name": "NICKOLAS",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-11",
"last_updated": "2012-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SC",
"license": "1423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.