Mira Kalman Sivan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002413 Issued in GA

Practice address

5462 Memorial Dr
Suite 101
Stone Mountain, GA 30083-3239

Phone

(404) 296-6000

NPI assigned

May 22, 2008

Last updated

May 22, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

New England College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Star Optometry Ga LLC

  dba InFocus Eyecare

  • Optometrist
  • Cumming, GA
  • NPI 1528944451
  Medicare reassignment NPD
• Dr. Daniel D. Gottlieb Optometrist, PC

  dba Gottlieb Vision Group

  • Low Vision Rehabilitation Optometrist
  • Alpharetta, GA
  • NPI 1720285307
  NPD (past)

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1407013840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CREEK RUN CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054374",
            "telephone_number": "770-752-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5462 MEMORIAL DR",
            "address_2": "SUITE 101",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833239",
            "telephone_number": "404-296-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVAN",
        "first_name": "MIRA",
        "middle_name": "KALMAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shani A Simon
• Shakenda Simpson, CNA
• Barbara Ann Sims-King, LPC
• Sirrah Health Group LLC (Rosiland Harris)
• Sistercare Inc
• Skin M.D. Inc
• Markebba Shiray Skylark, PA-C
• Robert Daniel Slade, PHARM D
• Shacindra Sloan, OTA
• SM Dentistry Inc (Park Family Dentistry)

• Optometrist in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.

Verify at the official NPI Registry.