Individual provider Active NPI

Justin Sasser, O.D.

  • Optometrist
  • Monroe, LA
National Provider Identifier
1528148251
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1535 Issued in LA
Practice address
4700 Millhave Road #1090
Monroe, LA 71203
Phone
(318) 325-4598
Fax
(318) 325-4924
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

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 1535 LA Primary

Addresses

Primary practice location

4700 Millhave Road #1090
Monroe, LA 71203

Mailing address

11103 West Avenue
Ste 6
San Antonio, TX 78213
Phone (210) 524-6803

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
I20210204000041 GA Practitioner - Optometry 6002817194 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1535LAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Lynn O.D. & Associates, PC CurrentSince Jan 1, 2021 Accepting new patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Oct 17, 2021 Accepting new patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Oct 17, 2021 Accepting new patients
Mark Lynn OD & Associates, PC Optometrist CurrentSince Jan 1, 2021 Accepting new patients

Locations

50 Main Street Market Pl SE
Ste 100
Cartersville, GA 30121
Phone (770) 382-6379

6700 Douglas Blvd
Ste 1550
Douglasville, GA 30135
Phone (770) 852-1002

4373 Jimmy Lee Smith Pkwy
Ste 101
Hiram, GA 30141
Phone (770) 943-2220

2929 Turner Hill Rd
Ste 2625
Lithonia, GA 30038
Phone (770) 482-5050

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528148251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVENUE",
            "address_2": "STE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78213",
            "telephone_number": "210-524-6803",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 MILLHAVE ROAD #1090",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71203",
            "telephone_number": "318-325-4598",
            "fax_number": "318-325-4924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASSER",
        "first_name": "JUSTIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.