Individual provider Active NPI

Nicholas E Barreca, MD

  • Ophthalmology Physician
  • Dothan, AL
National Provider Identifier
1487745279
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
8548 Issued in AL
Practice address
287 Healthwest Dr
Dothan, AL 36305
Phone
(334) 794-1968
Fax
(334) 792-8630
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 8548 AL Primary

Addresses

Primary practice location

287 Healthwest Dr
Dothan, AL 36305

Mailing address

287 Healthwest Dr
Dothan, AL 36305
Phone (334) 794-1968

Other identifiers 1

IdentifierTypeStateIssuer
051514594MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031112000434 AL Practitioner - Ophthalmology 6002729233 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8548ALMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical and Surgical Eyecare of Enterprise Ophthalmology CurrentSince Aug 4, 2015 Accepting new patients

Locations

100 Professional Ln
Ste A
Enterprise, AL 36330
Phone (334) 347-2999

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1487745279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 HEALTHWEST DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36305",
            "telephone_number": "334-794-1968",
            "fax_number": "334-792-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 HEALTHWEST DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36305",
            "telephone_number": "334-794-1968",
            "fax_number": "334-792-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRECA",
        "first_name": "NICHOLAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AL",
            "license": "8548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051514594",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.