NPIMap

Organization Active NPI

Eye Physicians and Surgeons of Augusta, PC

Doing business as Eye Guys

  • Ophthalmology Physician
  • Augusta, GA
National Provider Identifier
1386705069
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE PHYSICIANS AND SURGEONS OF AUGUSTA, PC
Doing business as
Eye Guys
Practice address
1330 Interstate Pkwy
Augusta, GA 30909-5625
Phone
(706) 651-2020
Fax
(706) 651-2032
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Authorized official

Name
Dr. Bradley Alan Bertram, M.D.NPI 1184785008
Title
President
Phone
(706) 651-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

1330 Interstate Pkwy
Augusta, GA 30909-5625

Mailing address

1330 Interstate Pkwy
Augusta, GA 30909-5625
Phone (706) 651-2020

Other identifiers 2

IdentifierTypeStateIssuer
40138OtherGAAVESIS PIN
52748856OtherBCBS OF GA-OPTICAL NUMBER

Other names 1

  • Eye Guys Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414001374 GA Part B Supplier - Clinic/Group Practice 4789678343 Receives reassigned benefits from 12 practitioners
Practice locations: Augusta, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1092312Eye Physicians and Surgeons of Augusta, PC1330 Interstate Parkway, Augusta, GA 30909Certificate of waiverNov 20, 2026

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

3658 J Dewey Gray Cir
Augusta, GA 30909
Phone (706) 651-2020

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565568000000",
    "number": "1386705069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 INTERSTATE PKWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309095625",
            "telephone_number": "706-651-2020",
            "fax_number": "706-651-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 INTERSTATE PKWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309095625",
            "telephone_number": "706-651-2020",
            "fax_number": "706-651-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE PHYSICIANS AND SURGEONS OF AUGUSTA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2019-08-12",
        "status": "A",
        "authorized_official_last_name": "BERTRAM",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-651-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS PIN",
            "identifier": "40138",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GA-OPTICAL NUMBER",
            "identifier": "52748856",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Guys",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.