Individual provider Active NPI

Joel James Schultz, O.D

  • Optometrist
  • Summerville, SC
National Provider Identifier
1497820716
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1011 Issued in SC
Practice address
105 S Cedar St
Suite F
Summerville, SC 29483-6078
Phone
(843) 832-4520
Fax
(843) 871-2269
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1011 SC Primary

Addresses

Primary practice location

105 S Cedar St
Suite F
Summerville, SC 29483-6078

Mailing address

1564 Glen Erin Dr
Mt Pleasant, SC 29464-7727
Phone (843) 442-9147

Other identifiers 1

IdentifierTypeStateIssuer
D10110MedicaidSC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070314000466 SC Practitioner - Optometry 9830292754 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Cornea and Refractive Surgery, PAGroup PAC ID 3375511041, 3 clinicians

Practice addresses (Care Compare)

574 Lone Tree Dr
Mt Pleasant, SC 29464-8170
Phone (843) 856-5275

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1011SCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Cornea & Refractive Surgery, PA CurrentSince Sep 24, 2024 Accepting new patients
Preferred Eyecare Center, LLC Optometrist CurrentSince May 6, 2023 Accepting new patients
F Mason Smith Optometrist Past Accepting new patients

Locations

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

574 Lone Tree Dr
Mt Pleasant, SC 29464
Phone (843) 856-5275

Organizations & group practices 4

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497820716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1564 GLEN ERIN DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294647727",
            "telephone_number": "843-442-9147",
            "fax_number": "843-856-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S CEDAR ST",
            "address_2": "SUITE F",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836078",
            "telephone_number": "843-832-4520",
            "fax_number": "843-871-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "JOEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D10110",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.