NPIMap

Organization Active NPI

Martinez Eye Associates LLC

Doing business as Martinez Eye Associates

  • Optometrist
  • Augusta, GA
National Provider Identifier
1457586976
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MARTINEZ EYE ASSOCIATES LLC
Doing business as
Martinez Eye Associates
Practice address
3412 Wrightsboro Rd
Suite 905
Augusta, GA 30909-2500
Phone
(706) 736-3937
Fax
(706) 736-3938
NPI assigned
May 28, 2009
Last updated
Jun 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Authorized official

Name
Dr. Abdul Daranijoh, ODNPI 1013000744
Title
Ceo
Phone
(812) 219-3207

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Corneal and Contact Management Optometrist 152WC0802X 2274 GA

Addresses

Primary practice location

3412 Wrightsboro Rd
Suite 905
Augusta, GA 30909-2500

Mailing address

PO Box 3151
Evans, GA 30809-0079
Phone (812) 219-3207

Other practice location 1

201 Harbison Blvd Ste 110
Columbia, SC 29212-2270
Phone (803) 732-1942

Other practice location 2

10136 Two Notch Rd Ste 107D
Columbia, SC 29229-4216
Phone (803) 760-7082

Other practice location 3

4086 Julep Way SW. Ste. A
Aiken, SC 29803-7846
Phone (803) 335-5434

Other identifiers 11

IdentifierTypeStateIssuer
000367155BMedicaidGA
000182861DMedicaidGA
154675884CMedicaidGA
D15972MedicaidSC
003242108AMedicaidGA
572742278AMedicaidGA
914781558BMedicaidGA
DA9564MedicaidSC
D14893MedicaidSC
D16356MedicaidSC
D20038MedicaidSC

Other names 1

  • Martinez Eye Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110725000017 SC Part B Supplier - Clinic/Group Practice 2860660529 Receives reassigned benefits from 3 practitioners
Practice locations: Columbia, SC
O20110726000186 GA Part B Supplier - Clinic/Group Practice 2860660529 Receives reassigned benefits from 5 practitioners
Practice locations: Augusta, GA

National Provider Directory

National Provider Directory

Locations

3412 Wrightsboro Rd
Ste 905
Augusta, GA 30909
Phone (706) 736-3937

4086 Julep Way SW
#A
Aiken, SC 29803
Phone (803) 335-5007

10136 Two Notch Rd
Ste 107D
Columbia, SC 29229
Phone (803) 477-3109

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1457586976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3151",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308090079",
            "telephone_number": "812-219-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 WRIGHTSBORO RD",
            "address_2": "SUITE 905",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309092500",
            "telephone_number": "706-736-3937",
            "fax_number": "706-736-3938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Harbison Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292122270",
            "country_code": "US",
            "telephone_number": "803-732-1942",
            "fax_number": "803-749-4344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10136 Two Notch Rd Ste 107D",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292294216",
            "country_code": "US",
            "telephone_number": "803-760-7082",
            "fax_number": "803-865-1856",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4086 Julep Way SW. Ste. A",
            "address_purpose": "LOCATION",
            "city": "Aiken",
            "state": "SC",
            "postal_code": "298037846",
            "country_code": "US",
            "telephone_number": "803-335-5434",
            "fax_number": "803-335-5520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARTINEZ EYE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-28",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "DARANIJOH",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-219-3207",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "GA",
            "license": "2274",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000367155B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000182861D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154675884C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D15972",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003242108A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "572742278A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "914781558B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9564",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D14893",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D16356",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D20038",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Martinez Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.