Active NPI
Benjamin Pascal Casella, O.D.
- Optometrist
- Augusta, GA
National Provider Identifier
1548457393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2449
- Practice address
- 767 Broad St
Augusta, GA 30901-1329 - Phone
- (706) 722-0817
- NPI assigned
- Sep 26, 2007
- Last updated
- Jan 21, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2449 | GA | Primary |
Addresses
Primary practice location
767 Broad St
Augusta, GA 30901-1329
Mailing address
767 Broad St
Augusta, GA 30901-1329
Phone (706) 722-0817
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2449 | GA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232496000000",
"number": "1548457393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "767 BROAD ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309011329",
"telephone_number": "706-722-0817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "767 BROAD ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309011329",
"telephone_number": "706-722-0817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASELLA",
"first_name": "BENJAMIN",
"middle_name": "PASCAL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-26",
"last_updated": "2009-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "2449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.