Individual provider Active NPI

David Jeffrey Matthews, O.D.

  • Optometrist
  • Columbia, SC
National Provider Identifier
1588775423
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1034 Issued in SC
Practice address
3928 Rosewood Dr
Columbia, SC 29205-3536
Phone
(803) 787-0107
Fax
(803) 787-0109
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1034 SC Primary

Addresses

Primary practice location

3928 Rosewood Dr
Columbia, SC 29205-3536

Mailing address

PO Box 50367
Columbia, SC 29250-0367
Phone (803) 787-0107

Other identifiers 3

IdentifierTypeStateIssuer
D10343MedicaidSC
0005811543OtherETNA / OWENS CORNING
410035583OtherSCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20040220000363 SC Practitioner - Optometry 7113822685 Reassigns benefits to 1 organization
Practice locations: Columbia, SC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Devine Eyes IncGroup PAC ID 2769387232, 2 clinicians

Practice addresses (Care Compare)

2421 Devine St
Columbia, SC 29205-2405
Phone (803) 376-4545

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Devine Eyes Inc Optometrist CurrentSince Jan 23, 2018 Accepting new patients
Palmetto Eye Associates Optometrist PastSince May 1, 2003 Accepting new patients

Locations

2421 Devine St
Columbia, SC 29205
Phone (803) 376-4545

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588775423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50367",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292500367",
            "telephone_number": "803-787-0107",
            "fax_number": "803-787-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3928 ROSEWOOD DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292053536",
            "telephone_number": "803-787-0107",
            "fax_number": "803-787-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "DAVID",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D10343",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ETNA / OWENS CORNING",
            "identifier": "0005811543",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410035583",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.