Joel L. Penegar, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0933 Issued in NC

Practice address

1007 Skyway Dr
Monroe, NC 28110-3050

Phone

(704) 289-1547

Fax

(704) 291-9441

NPI assigned

Nov 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

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 and National Provider Directory roles.

• Eyecarecenter OD PA

  • Optometrist
  • Cary, NC
  • NPI 1417973546
  Medicare reassignment NPD
• Eyecarecenter OD PA

  • Optometrist
  • Monroe, NC
  • NPI 1932152964
  NPD
• Eyecarecenter, O.D., P.a.

  • Optometrist
  • Fayetteville, NC
  • NPI 1336876788
  NPD

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1598944845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207261",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207261",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 SKYWAY DR",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281103050",
            "telephone_number": "704-289-1547",
            "fax_number": "704-291-9441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 Skyway Dr",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281103001",
            "country_code": "US",
            "telephone_number": "704-296-0818",
            "fax_number": "704-225-9115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5850 W Highway 74 Ste 116",
            "address_purpose": "LOCATION",
            "city": "Indian Trail",
            "state": "NC",
            "postal_code": "280793476",
            "country_code": "US",
            "telephone_number": "704-234-7355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENEGAR",
        "first_name": "JOEL",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-02",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "0933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLCROSS",
            "identifier": "09703",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909703",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.