Individual provider Active NPI

Steven K Dean, OD

  • Optometrist
  • Sumter, SC
National Provider Identifier
1619955788
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1137 Issued in SC
Practice address
1057 Broad St
Jessamine Mall
Sumter, SC 29150-2567
Phone
(803) 775-7877
Fax
(803) 934-0547
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 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 1137 SC Primary

Addresses

Primary practice location

1057 Broad St
Jessamine Mall
Sumter, SC 29150-2567

Mailing address

1057 Broad St
Jessamine Mall
Sumter, SC 29150-2567
Phone (803) 775-7877

Other identifiers 1

IdentifierTypeStateIssuer
D11379MedicaidSC

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
I20051115000381 SC Practitioner - Optometry 9436178803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1057 Broad St
Sumter, SC 29150-2567
Phone (803) 775-7877

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Manter Optometric, LLC Optometrist CurrentSince Aug 16, 2007 Accepting new patients
East Coast Optometric, Inc. Optometrist Past Accepting new patients

Locations

1057 Broad St
Sumter, SC 29150
Phone (803) 775-7877

1057 Broad St
Ste 1
Sumter, SC 29150
Phone (803) 494-5214

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1619955788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 BROAD ST",
            "address_2": "JESSAMINE MALL",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502567",
            "telephone_number": "803-775-7877",
            "fax_number": "803-934-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 BROAD ST",
            "address_2": "JESSAMINE MALL",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502567",
            "telephone_number": "803-775-7877",
            "fax_number": "803-934-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "STEVEN",
        "middle_name": "K",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D11379",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.