Individual provider Active NPI

Bupathi Dissanayake-Musalem, O.D.

  • Optometrist
  • Cary, NC
National Provider Identifier
1497043335
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2308 Issued in NC
Practice address
1975 High House Rd
Cary, NC 27519-8452
Phone
(919) 461-0771
NPI assigned
Jul 13, 2011
Last updated
Oct 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2308 NC Primary

Addresses

Primary practice location

1975 High House Rd
Cary, NC 27519-8452

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20140805000552 NC Practitioner - Optometry 9638396302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Nova Southeastern Univ College of Dental Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1975 High House Rd
Cary, NC 27519-8452
Phone (919) 461-0771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2308NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jun 25, 2017 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jun 25, 2017 Accepting new patients
Eye Care Associates OD PA Optometrist Past Accepting new patients
Myeyedr Optometry of North Carolina Optometrist Past Accepting new patients

Locations

800 W Williams St
Ste 164
Apex, NC 27502
Phone (919) 272-9970

1975 High House Rd
Cary, NC 27519
Phone (919) 461-0771

2042 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 851-0093

2075 Renaissance Park Pl
Cary, NC 27513
Phone (919) 391-7224

2346 Walnut St
Cary, NC 27518
Phone (919) 851-0093

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

3354 W Friendly Ave
Greensboro, NC 27410
Phone (336) 387-0930

3354 W Friendly Ave
Ste 147
Greensboro, NC 27410
Phone (336) 387-0930

3603 Davis Dr
Ste 100
Morrisville, NC 27560
Phone (919) 234-4888

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1497043335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 HIGH HOUSE RD",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275198452",
            "telephone_number": "919-461-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISSANAYAKE-MUSALEM",
        "first_name": "BUPATHI",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.