Individual provider Active NPI

Jennifer Robyn Switak, O.D.

  • Optometrist
  • Bluffton, SC
National Provider Identifier
1417050790
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1344 Issued in SC
Practice address
104 Buckwalter Pkwy
Unit 1 C
Bluffton, SC 29910-4131
Phone
(843) 757-9588
Fax
(843) 757-9589
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 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 1344 SC Primary

Addresses

Primary practice location

104 Buckwalter Pkwy
Unit 1 C
Bluffton, SC 29910-4131

Mailing address

16 Charlesfort PL
Hilton Head Island, SC 29926-1988
Phone (843) 422-5761

Other identifiers 4

IdentifierTypeStateIssuer
26449OtherSCSPECTERA
50960OtherSCDAVIS
D13448MedicaidSC
552832OtherSCNVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20050914000633 SC Practitioner - Optometry 3476586041 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Site of Bluffton LLCGroup PAC ID 9335147560, 3 clinicians
Eye Site LLCGroup PAC ID 4789617358, 2 clinicians

Practice addresses (Care Compare)

104 Buckwalter Pkwy
Bluffton, SC 29910-4129
Phone (843) 757-9588

25 Pembroke Dr
Hilton Head, SC 29926-2259
Phone (843) 681-3396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1344SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Site LLC Optometrist CurrentSince Mar 1, 2005 Accepting new patients
Eye Site of Bluffton LLC Optometrist CurrentSince Nov 1, 2006 Accepting new patients
Ridgeland Eye Associates LLC Past Accepting new patients

Locations

104 Buckwalter Pkwy
Ste 1C
Bluffton, SC 29910
Phone (843) 540-2327

25 Pembroke Dr
Hilton Head Island, SC 29926
Phone (843) 681-3010

Organizations & group practices 3

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": "1463011200000",
    "number": "1417050790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CHARLESFORT PL",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299261988",
            "telephone_number": "843-422-5761",
            "fax_number": "843-757-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BUCKWALTER PKWY",
            "address_2": "UNIT 1 C",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104131",
            "telephone_number": "843-757-9588",
            "fax_number": "843-757-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWITAK",
        "first_name": "JENNIFER",
        "middle_name": "ROBYN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "26449",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "50960",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D13448",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "552832",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

Verify at the official NPI Registry.