Andrew Glen Knezich, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001803 Issued in GA

Practice address

1501 Newcastle St
Brunswick, GA 31520-6806

Phone

(912) 280-0012

Fax

(912) 280-0991

NPI assigned

Nov 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• American Vision Center

  • Eyewear Supplier
  • Brunswick, GA
  • NPI 1184785594
  NPD (past)
• Optical Illusions, P.C.

  dba Vision Source Family Eye Care

  • Optometrist
  • Brunswick, GA
  • NPI 1669521886
  NPD (past)
• Optical Illusions, PC

  dba Vision Source Partners

  • Optometrist
  • Saint Marys, GA
  • NPI 1346390895
  NPD (past)

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1578546214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 VILLAGE AT GLYNN PLACE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31525",
            "telephone_number": "912-264-6000",
            "fax_number": "912-280-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NEWCASTLE ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315206806",
            "telephone_number": "912-280-0012",
            "fax_number": "912-280-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEZICH",
        "first_name": "ANDREW",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "582646940",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209089721A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "POO149589",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "GK22894",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED",
            "identifier": "GA1803",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "32774",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6599375",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Kirk, AGACNP
• Donna Kirkland, LPN
• Claire Marie Kitchen
• Stephen F Kitchen, MD
• Peter Richard Klein
• Amelia Knight
• Ardell Buckey Knight
• Rebecca Knor, ATC
• Emily Nole Knott, PA-C
• Knowles Exams & More

• Optometrist in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.