Organization Active NPI

Pandya-Lipman Eye Specialist, PLLC

  • Pediatric Optometrist
  • Southaven, MS
National Provider Identifier
1528261815
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
16645 Issued in MS
Legal business name
PANDYA-LIPMAN EYE SPECIALIST, PLLC
Doing business as
Pandya-Lipman Eye Specialist, PLLC
Practice address
60 Physicians LN
Suite 2
Southaven, MS 38671-6122
Phone
(662) 349-3025
Fax
(662) 349-0708
NPI assigned
Jun 6, 2007
Last updated
Jan 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Authorized official

Name
Mrs. Traci L Cato
Title
Office Manager
Phone
(662) 349-3025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X 16645 MS Primary

Addresses

Primary practice location

60 Physicians LN
Suite 2
Southaven, MS 38671-6122

Mailing address

60 Physicians LN
Suite 1
Southaven, MS 38671-6122
Phone (662) 349-3025

Other names 1

  • Pandya-Lipman Eye Specialist, PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080110000372 MS Part B Supplier - Clinic/Group Practice 3870673221 Receives reassigned benefits from 2 practitioners
Practice locations: Southaven, MS
O20201028003109 TN Part B Supplier - Clinic/Group Practice 3870673221 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

3964 Goodman Rd E
Ste 125
Southaven, MS 38672
Phone (662) 890-7361

1715 Kirby Pkwy
Ste 101
Memphis, TN 38120
Phone (901) 754-3937

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1528261815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 PHYSICIANS LN",
            "address_2": "SUITE 1",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716122",
            "telephone_number": "662-349-3025",
            "fax_number": "662-349-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PHYSICIANS LN",
            "address_2": "SUITE 2",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716122",
            "telephone_number": "662-349-3025",
            "fax_number": "662-349-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANDYA-LIPMAN EYE SPECIALIST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "CATO",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-349-3025",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MS",
            "license": "16645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pandya-Lipman Eye Specialist, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.