Individual provider Active NPI

Kajene Thasan Vethanayagam, O.D.

  • Optometrist
  • Athens, GA
National Provider Identifier
1407412471
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003162 Issued in GA
Practice address
Thomas Eye Center
1077 Baxter Street, Suite 100
Athens, GA 30606-3767
Phone
(706) 549-7757
Fax
(706) 549-4186
NPI assigned
May 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003162 GA Primary

Addresses

Primary practice location

Thomas Eye Center
1077 Baxter Street, Suite 100
Athens, GA 30606-3767

Mailing address

Thomas Eye Center
1077 Baxter Street, Suite 100
Athens, GA 30606-3767
Phone (706) 549-7757

Other names 1

  • Kajene Murugathasan Former name

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
I20190820002474 GA Practitioner - Optometry 3173851839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens Eye Care LLCGroup PAC ID 0547792418, 3 clinicians

Practice addresses (Care Compare)

1077 Baxter St
Suite 100
Athens, GA 30606-3767
Phone (706) 549-7757

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003162GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Eye Care, LLC Optometrist Current Accepting new patients
Athens Eye Care LLC Optometrist CurrentSince Jul 31, 2024 Accepting new patients

Locations

1077 Baxter St
Ste 100
Athens, GA 30606
Phone (706) 549-7757

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1407412471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THOMAS EYE CENTER",
            "address_2": "1077 BAXTER STREET, SUITE 100",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306063767",
            "telephone_number": "706-549-7757",
            "fax_number": "706-549-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THOMAS EYE CENTER",
            "address_2": "1077 BAXTER STREET, SUITE 100",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306063767",
            "telephone_number": "706-549-7757",
            "fax_number": "706-549-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETHANAYAGAM",
        "first_name": "KAJENE",
        "middle_name": "THASAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAJENE",
            "last_name": "MURUGATHASAN",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.