Individual provider Active NPI

Peter J Moresi, OD

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1386747640
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT1083 Issued in GA
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

Updated by the provider on Feb 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
204999784OtherGATAX 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150331000726 GA Practitioner - Optometry 6608193719 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT1083GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Doctors of Georgia Optometrist CurrentSince Dec 23, 2025 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.

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

Verify at the official NPI Registry.