Individual provider Active NPI

Edward Gustavo Mintz, MD

  • Ophthalmology Physician
  • Lexington, SC
National Provider Identifier
1629030283
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
16570 Issued in SC
Practice address
100 Palmetto Park Blvd
Lexington, SC 29072
Phone
(803) 806-0080
Fax
(803) 356-0668
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 16570 SC Primary

Addresses

Primary practice location

100 Palmetto Park Blvd
Lexington, SC 29072

Mailing address

PO Box 60371
Charlotte, NC 28260-0371
Phone (803) 806-0080

Other identifiers 1

IdentifierTypeStateIssuer
165706MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edward.mintz.p1@direct.columbiaeyeclinic.nextgenshare.com

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100519000607 SC Practitioner - Ophthalmology 6204731458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of South Carolina School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Eye Clinic PAGroup PAC ID 8426069907, 20 clinicians

Practice addresses (Care Compare)

1920 Pickens St
Columbia, SC 29201-2632
Phone (803) 779-3070

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16570SCMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Eye Clinic PA Ophthalmology CurrentSince Jul 19, 1993 Accepting new patients
Columbia Eye Surg Center Inc Past Accepting new patients

Locations

1920 Pickens St
Columbia, SC 29201
Phone (803) 254-7732

100 Palmetto Park Blvd
Lexington, SC 29072
Phone (803) 806-0075

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1629030283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60371",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600371",
            "telephone_number": "803-806-0080",
            "fax_number": "803-356-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PALMETTO PARK BLVD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "29072",
            "telephone_number": "803-806-0080",
            "fax_number": "803-356-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTZ",
        "first_name": "EDWARD",
        "middle_name": "GUSTAVO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "16570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165706",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edward.mintz.p1@direct.columbiaeyeclinic.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1920 Pickens St",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292012632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

Verify at the official NPI Registry.