Derrick Badaracco

Primary specialty

OptometristTaxonomy code 152W00000X

License

GA 2860 Issued in GA

Practice address

3290 Buford Dr
Suite B-2
Buford, GA 30519-4928

Phone

(724) 799-1387

NPI assigned

Jul 1, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

State University of New York - State College Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Eyedoc Investments LLC

  • Optometrist
  • Buford, GA
  • NPI 1174073134

  GA, Optometrist

  Medicare reassignment NPD Authorized official
• Nevus Eye LLC

  • Optometrist
  • Alpharetta, GA
  • NPI 1851110811

  GA, Optometrist

  Medicare reassignment NPD Authorized official
• Mark Lynn OD & Associates, PC

  • Optometrist
  • Lithonia, GA
  • NPI 1417055203

  GA, Optometrist

  Medicare reassignment NPD
• Mark Lynn O.D. & Associates, PC

  • Eyewear Supplier
  • Savannah, GA
  • NPI 1518375500
  NPD

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1457767253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4180 BUTLER DR",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303411361",
            "telephone_number": "724-799-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 BUFORD DR",
            "address_2": "SUITE B-2",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305194928",
            "telephone_number": "724-799-1387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADARACCO",
        "first_name": "DERRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002352",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "GA 2860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke A Atkinson, LPC CPCS
• Robert Atkinson
• Atl Home Care Agency LLC
• B & B Medical Transport, LLC
• B'ZZ Hive Cranial Prosthetic Wigs
• Eric Bailey
• Jennifer Roberts Bailey, COTA/L
• Ninola Balaban
• Balanced Life Counseling, LLC
• Jeremy Jarabas Banas, PT, DPT

• All providers in Buford, GA
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.