Individual provider Active NPI

Chelsea Sceusa, OD

  • Optometrist
  • Pooler, GA
National Provider Identifier
1417323403
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2270 Issued in SC
Practice address
200 Mosaic Cir
Pooler, GA 31322-5025
Phone
(912) 348-4584
NPI assigned
Aug 13, 2015
Last updated
Nov 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003118 PA
Optometrist 152W00000X 27OA00662500 NJ
Optometrist 152W00000X OPT003379 GA
Optometrist 152W00000X 2270 SC Primary

Addresses

Primary practice location

200 Mosaic Cir
Pooler, GA 31322-5025

Mailing address

PO Box 4495
West Columbia, SC 29171-4495
Phone (720) 309-9464

Other practice location 1

1903 N Highway 17 Ste 100
MT Pleasant, SC 29464-9481
Phone (843) 216-1338

Other identifiers 1

IdentifierTypeStateIssuer
2270OtherSCSTATE LICENSE

Other names 1

  • Chelsea Ryzuk Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.revolutionehr.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA, SC, GA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20151216000317 NJ Practitioner - Optometry 6002117058 Reassigns benefits to 1 organization
I20160121000102 PA Practitioner - Optometry 6002117058 Reassigns benefits to 1 organization
I20210818002626 SC Practitioner - Optometry 6002117058 Reassigns benefits to 3 organizations
I20211205000024 GA Practitioner - Optometry 6002117058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3050 Ashley Town Ctr Dr
Charleston, SC 29414-5664
Phone (843) 460-2013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003379GAMDOptometrist
2270SCMDOptometrist
PENDINGGAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swift Optometry Care PC Optometrist CurrentSince Apr 7, 2022 Accepting new patients
Sight Services P.C. Optometrist CurrentSince Dec 1, 2015 Accepting new patients
Comprehensive Eyecare at West Ashley LLC Optometrist CurrentSince Mar 1, 2023 Accepting new patients
Eye Care Associates of Co LLC Optometrist PastSince Dec 6, 2022 Accepting new patients
Dr Chelsea Ryzuk Optometrist Past Accepting new patients
F Mason Smith Optometrist Past Accepting new patients
Shine Optical, Inc Optometrist PastSince Jul 13, 2011 Accepting new patients

Locations

22 Maple Ridge Dr
Cartersville, GA 30121
Phone (770) 606-8800

1155 E Jersey St
Elizabeth, NJ 07201
Phone (732) 987-5122

65 Jay St
Newark, NJ 07103
Phone (973) 447-8882

250 Skillman St
Ste 202
Brooklyn, NY 11205

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

2990 Holme Ave
Philadelphia, PA 19136
Phone (215) 335-2100

100 Edella Rd
South Abington Township, PA 18411
Phone (570) 586-1002

3050 Ashley Town Center Dr
Charleston, SC 29414
Phone (843) 460-2001

Interoperability endpoints

  • Direct secure messaging: chelsea.ryzuk@uprisedirect.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1417323403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4495",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291714495",
            "telephone_number": "720-309-9464",
            "fax_number": "720-222-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MOSAIC CIR",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313225025",
            "telephone_number": "912-348-4584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1903 N Highway 17 Ste 100",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "SC",
            "postal_code": "294649481",
            "country_code": "US",
            "telephone_number": "843-216-1338",
            "fax_number": "843-216-1487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCEUSA",
        "first_name": "CHELSEA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003118",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00662500",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003379",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2270",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.revolutionehr.com",
            "affiliation": "N",
            "address_1": "2111 Pooler Pkwy",
            "city": "Pooler",
            "state": "GA",
            "country_code": "US",
            "postal_code": "313224207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHELSEA",
            "last_name": "RYZUK",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pooler, GA

Sources for this page

Verify at the official NPI Registry.