Individual provider Active NPI

Anthony Dylan Reach, O.D.

  • Optometrist
  • Acworth, GA
National Provider Identifier
1609901479
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1859 Issued in GA
Practice address
4900 Ivey Rd NW Ste 1226
Acworth, GA 30101-4108
Phone
(770) 974-3153
Fax
(770) 974-3154
NPI assigned
Feb 22, 2007
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1859 GA Primary

Addresses

Primary practice location

4900 Ivey Rd NW Ste 1226
Acworth, GA 30101-4108

Mailing address

4900 Ivey Rd NW Ste 1226
Acworth, GA 30101-4108
Phone (770) 974-3153

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040503000351 GA Practitioner - Optometry 8820086655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A. Dylan Reach, OD, PCGroup PAC ID 9133252539, 4 clinicians

Practice addresses (Care Compare)

4900 Ivey Rd NW
Suite 12226
Acworth, GA 30101-4001
Phone (770) 974-3153

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1859GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
A. Dylan Reach, OD, PC Optometrist CurrentSince Nov 1, 2000 Accepting new patients
Precision Eyecare, LLC Optometrist PastSince Feb 8, 2005 Accepting new patients

Locations

3459 Acworth Due West Rd NW
Ste 101
Acworth, GA 30101
Phone (404) 667-0533

4900 Ivey Rd NW
Ste 12226
Acworth, GA 30101
Phone (770) 974-3153

4900 Ivey Rd NW
Ste 1226
Acworth, GA 30101
Phone (770) 974-3153

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1609901479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 IVEY RD NW STE 1226",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014108",
            "telephone_number": "770-974-3153",
            "fax_number": "770-974-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 IVEY RD NW STE 1226",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014108",
            "telephone_number": "770-974-3153",
            "fax_number": "770-974-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REACH",
        "first_name": "ANTHONY",
        "middle_name": "DYLAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

Verify at the official NPI Registry.