Individual provider Active NPI

Arun Thoppe Subramanian, OD FAAO

  • Optometrist
  • Kernersville, NC
National Provider Identifier
1538129291
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2006 Issued in NC
Practice address
1635 NC Highway 66 S Ste 155
Kernersville, NC 27284-3855
Phone
(336) 992-0010
Fax
(336) 245-4636
NPI assigned
Mar 27, 2006
Last updated
Sep 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2006 NC Primary

Addresses

Primary practice location

1635 NC Highway 66 S Ste 155
Kernersville, NC 27284-3855

Mailing address

1000 Southlake CT
Lexington, NC 27295-9829
Phone (713) 446-9614

Other practice location 1

1311 N Elm St
Greensboro, NC 27401-6305
Phone (336) 378-9993

Other identifiers 2

IdentifierTypeStateIssuer
P00450033OtherNCRAILROAD MEDICARE
5905630MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20060615000139 NC Practitioner - Optometry 8628080561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1635 NC Hwy 66 S
Suite 155
Kernersville, NC 27284-3855
Phone (336) 992-0010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kernersville Eye Associates, OD PA Optometrist Current Accepting new patients
Kernersville Eye Associates, O.D., P.a. Optometrist CurrentSince Jun 30, 2020 Accepting new patients
Shapiro Eye Care PA Past Accepting new patients

Locations

2628 S Main St
High Point, NC 27263
Phone (336) 869-9644

1635 NC Highway 66 S
Ste 155
Kernersville, NC 27284
Phone (336) 375-6990

204 Ingram Dr
King, NC 27021
Phone (336) 235-4004

3475 Parkway Village Cir
Winston Salem, NC 27127
Phone (336) 771-7322

Organizations & group practices 3

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1538129291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SOUTHLAKE CT",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272959829",
            "telephone_number": "713-446-9614",
            "fax_number": "336-245-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 NC HIGHWAY 66 S STE 155",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272843855",
            "telephone_number": "336-992-0010",
            "fax_number": "336-245-4636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1311 N Elm St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274016305",
            "country_code": "US",
            "telephone_number": "336-378-9993",
            "fax_number": "336-274-5884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUBRAMANIAN",
        "first_name": "ARUN",
        "middle_name": "THOPPE",
        "name_prefix": "Dr.",
        "credential": "OD FAAO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00450033",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905630",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.