Individual provider Active NPI

Radhi Daya, OD

  • Optometrist
  • Southaven, MS
National Provider Identifier
1518645019
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1080 Issued in MS
Practice address
940 Church Rd W Ste C
Southaven, MS 38671-9611
Phone
(662) 331-3937
Fax
(662) 404-8884
NPI assigned
Jul 6, 2023
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3820 TN
Optometrist 152W00000X 1080 MS Primary

Addresses

Primary practice location

940 Church Rd W Ste C
Southaven, MS 38671-9611

Mailing address

940 Church Rd W Ste C
Southaven, MS 38671-9611
Phone (662) 331-3937

Other practice location 1

4281 American Way
Memphis, TN 38118-2014
Phone (901) 365-0930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20240825000016 MS Practitioner - Optometry 5991244709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amin Eye Care, PLLCGroup PAC ID 9931504594, 2 clinicians

Practice addresses (Care Compare)

940 Church Rd W
Suite C
Southaven, MS 38671-9611
Phone (662) 331-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1080MSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Amin Eye Care, PLLC Optometrist CurrentSince Aug 1, 2024 Accepting new patients

Locations

940 Church Rd W
Ste C
Southaven, MS 38671
Phone (662) 331-3937

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.

NPI Registry JSON

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1518645019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 CHURCH RD W STE C",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719611",
            "telephone_number": "662-331-3937",
            "fax_number": "662-404-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 CHURCH RD W STE C",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719611",
            "telephone_number": "662-331-3937",
            "fax_number": "662-404-8884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4281 American Way",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381182014",
            "country_code": "US",
            "telephone_number": "901-365-0930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAYA",
        "first_name": "RADHI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3820",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "1080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.