Matthew David Vizithum, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1725 Issued in NC

Practice address

200 W Weaver St
Suite 1
Carrboro, NC 27510-6009

Phone

(919) 968-6300

Fax

(919) 968-0403

NPI assigned

Jul 21, 2006

Last updated

Apr 19, 2012By the provider in NPPES

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 3

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carrboro Family Vision LLCGroup PAC ID 8820058597, 5 clinicians

Eyecare Specialties of North Carolina OD PLLCGroup PAC ID 8820462252, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Carrboro Family Vision LLC

  • Optometrist
  • Carrboro, NC
  • NPI 1154340149
  Medicare reassignment Care Compare group NPD
• Eyecare Specialties of North Carolina OD PLLC

  • Optometrist
  • Holly Springs, NC
  • NPI 1699483586
  Medicare reassignment Care Compare group NPD
• Adler Eye Associates, O.D., P.a.

  • Optometrist
  • Chapel Hill, NC
  • NPI 1063538668
  NPD (past)
• Spectrum Family Eye Center Optometric PA

  • Optometrist
  • Pinehurst, NC
  • NPI 1912934704
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1578584371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 W MAIN ST",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "27510",
            "telephone_number": "919-968-6300",
            "fax_number": "919-968-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W WEAVER ST",
            "address_2": "SUITE 1",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275106009",
            "telephone_number": "919-968-6300",
            "fax_number": "919-968-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIZITHUM",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE MPIN",
            "identifier": "1873183",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "396884",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093K8",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Vail
• Rooney Noelle Valentine, DDS
• Shanika Janiece Varghese, LCMHC
• Jaymie Lynn Vernooy
• Visiting Angels of Central North Carolina, Inc.
• Anna Wagner, RDN, LDN
• Lauren Janette Wagner, OTR/L
• Walgreen Co (Walgreens #19300)
• Tracy Anne Ware, MD
• We OT PLLC

• Optometrist in Carrboro, NC
• Providers in Carrboro, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.