NPIMap

Myeyedr Optometry of Georgia, LLC

Organization Active NPI Optometrist · Macon, GA

NPI 1477070100 · NPPES record last updated May 26, 2022

Key facts

NPI
1477070100
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF GEORGIA, LLC
Practice address
3801 Northside Dr
Macon, GA 31210-2418
NPI assigned
Aug 23, 2017
Organization subpart
No

Authorized official

Name
Sue Downes
Title
Secretary
Phone
(703) 847-8899

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Practitioners 102

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 102

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2291055Myeyedr Optometry of Georgia, LLC
3801 Northside Drive, Macon, GA 31210		Certificate of waiverOct 3, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Myeyedr Optometry of Georgia, LLC
3801 Northside Dr, Macon, GA 31210-2418 · (478) 475-1600		 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignment
Participating since Feb 5, 2014

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140428000739 GA Part B Supplier - Clinic/Group Practice 8224261201 Receives reassigned benefits from 207 practitioners
This NPI is an additional NPI on the enrollment
O20220502001396 GA DME Supplier - Physician - Optometrist 8224261201 Practice locations: Macon, GA

National Provider Directory

Tax ID family
Myeyedr Optometry of Ga (43 organizations share this tax ID)

Locations

2003 Commerce Dr
Kingsland, GA 31548
Phone (912) 882-3040

1950 Old Gallows Rd
Ste 210
Vienna, VA 22182

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP		 152W00000X Yes

Addresses

Primary practice location

3801 Northside Dr
Macon, GA 31210-2418

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names

  • MyEyeDr. Doing business as

Other providers in Macon, GA

All providers in Macon, GA · Optometrist in Georgia

Sources for this page

Verify at the official NPI Registry.