Individual provider Active NPI

Nicol L. Mayfield, O.D.

  • Optometrist
  • Goose Creek, SC
National Provider Identifier
1487604898
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2148 Issued in SC
Practice address
110 Nnptc Cir
Goose Creek, SC 29445-6314
Phone
(843) 794-6881
Fax
(843) 794-6041
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2148 SC Primary

Addresses

Primary practice location

110 Nnptc Cir
Goose Creek, SC 29445-6314

Mailing address

1233 Blue Sky LN
Charleston, SC 29492-8158
Phone (402) 312-6319

Other identifiers 1

IdentifierTypeStateIssuer
SCH673J061OtherSCMEDICARE PTAN

Other names 1

  • Nicol L Matusik Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, SC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20090209000414 NE Practitioner - Optometry 4688686801
I20200528001616 SC Practitioner - Optometry 4688686801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1125NEMDClinical Social Worker
2148SCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Eyecare Center, LLC Optometrist CurrentSince May 3, 2021 Accepting new patients
F Mason Smith Optometrist Past Accepting new patients
Lincoln Vision Clinic, P.C. Optometrist Past Accepting new patients
Lincoln Vision Center PC Optometrist Past Accepting new patients
Cayuga Medical Associates, PC Past Accepting new patients
Robert J. Arleo, MD,PC PastSince Dec 23, 2005 Accepting new patients

Locations

1118 Park West Blvd
Ste 5
Mt Pleasant, SC 29466
Phone (843) 856-4775

Organizations & group practices 6

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1487604898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 BLUE SKY LN",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294928158",
            "telephone_number": "402-312-6319",
            "fax_number": "607-257-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NNPTC CIR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294456314",
            "telephone_number": "843-794-6881",
            "fax_number": "843-794-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYFIELD",
        "first_name": "NICOL",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "SCH673J061",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOL",
            "last_name": "MATUSIK",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Goose Creek, SC

Sources for this page

Verify at the official NPI Registry.