Active NPI
Peter J Moresi, OD
- Optometrist
- Atlanta, GA
National Provider Identifier
1386747640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT1083
- Practice address
- 2549 Piedmont Rd
Suite 120
Atlanta, GA 30324 - Phone
- (678) 939-2709
- Fax
- (404) 601-0795
- NPI assigned
- Sep 5, 2006
- 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 | OPT1083 | GA | Primary |
Addresses
Primary practice location
2549 Piedmont Rd
Suite 120
Atlanta, GA 30324
Mailing address
1950 Old Gallows Rd
Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204999784 | Other | GA | TAX ID |
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: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT1083 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Doctors of Georgia | Optometrist | Current | Accepting new patients |
Locations
2825 Ledo Rd
Albany, GA 31707
Phone (229) 883-6432
641 Veterans Pkwy S
Moultrie, GA 31788
Phone (229) 890-7416
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Albany, GA
- NPI 1992595326
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454284800000",
"number": "1386747640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 OLD GALLOWS RD",
"address_2": "STE 520",
"city": "VIENNA",
"state": "VA",
"postal_code": "221823970",
"telephone_number": "703-847-8899",
"fax_number": "703-991-0514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2549 PIEDMONT RD",
"address_2": "SUITE 120",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30324",
"telephone_number": "678-939-2709",
"fax_number": "404-601-0795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORESI",
"first_name": "PETER",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-05",
"last_updated": "2016-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "OPT1083",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "204999784",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.