Individual provider Active NPI

Nikil A Patel, O.D.

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1528119245
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002180 Issued in GA
Practice address
2900 Cumberland Mall SE
Atlanta, GA 30339-8107
Phone
(770) 431-1713
Fax
(770) 431-1714
NPI assigned
Jan 16, 2007
Last updated
Sep 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002180 GA
Optometrist 152W00000X 18003283A IN
Optometrist 152W00000X OPT002180 GA Primary

Addresses

Primary practice location

2900 Cumberland Mall SE
Atlanta, GA 30339-8107

Mailing address

4688 Prater Way SE
Smyrna, GA 30080-9259
Phone (404) 983-8420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20050316000636 GA Practitioner - Optometry 4385699966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vani Vision, P.C.Group PAC ID 4688712367, 2 clinicians

Practice addresses (Care Compare)

2900 Cumberland Semall
Atlanta, GA 30339-8107
Phone (770) 431-1713

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002180GAMDOptometrist
18003283AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vani Vision, P.C. Optometrist CurrentSince Aug 9, 2009 Accepting new patients

Locations

2900 Cumberland Mall SE
Atlanta, GA 30339
Phone (770) 431-1709

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1528119245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4688 PRATER WAY SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300809259",
            "telephone_number": "404-983-8420",
            "fax_number": "770-431-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CUMBERLAND MALL SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303398107",
            "telephone_number": "770-431-1713",
            "fax_number": "770-431-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIKIL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "002180",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003283A",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.