Active NPI
Malissa T Mathis, OD
- Optometrist
- Gaffney, SC
National Provider Identifier
1487659256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1092
- Practice address
- 1506 N Limestone St
Gaffney, SC 29340-4747 - Phone
- (864) 489-2016
- Fax
- (864) 488-1123
- NPI assigned
- Jun 16, 2005
- Last updated
- Feb 1, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1092 | SC | Primary |
Addresses
Primary practice location
1506 N Limestone St
Gaffney, SC 29340-4747
Mailing address
180 N Dean St
Spartanburg, SC 29302-1517
Phone (864) 583-3125
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1506 N Limestone St
Gaffney, SC 29340-1205
Phone (864) 489-2016
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 29 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1092 | SC | MD | Physical Therapist |
Organizations & group practices 1
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.
-
- Optometrist
- Spartanburg, SC
- NPI 1255357356
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359676800000",
"number": "1487659256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 N DEAN ST",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293021517",
"telephone_number": "864-583-3125",
"fax_number": "864-542-1367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1506 N LIMESTONE ST",
"city": "GAFFNEY",
"state": "SC",
"postal_code": "293404747",
"telephone_number": "864-489-2016",
"fax_number": "864-488-1123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "MALISSA",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-16",
"last_updated": "2013-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SC",
"license": "1092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaffney, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.