NPIMap

Organization Active NPI

Beaufort Eye Center P a

  • Ophthalmology Physician
  • Port Royal, SC
National Provider Identifier
1639398472
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
BEAUFORT EYE CENTER P A
Practice address
1664 Ribaut Rd
Port Royal, SC 29935-1708
Phone
(843) 522-8466
NPI assigned
Apr 24, 2007
Last updated
Sep 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Demetrajane Kokinakis, D.O.NPI 1770579013
Title
Owner/Physician
Phone
(843) 522-8466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1664 Ribaut Rd
Port Royal, SC 29935-1708

Mailing address

1664 Ribaut Rd
Port Royal, SC 29935-1708
Phone (843) 522-8466

Other practice location 1

103 Okatie Center Blvd N Ste 103
Okatie, SC 29909-3765
Phone (843) 706-2440

Other names 1

  • Beaufort Eye Clinic P A Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071011000712 SC Part B Supplier - Clinic/Group Practice 1052407640 Receives reassigned benefits from 6 practitioners
Practice locations: Okatie, SC; Port Royal, SC; Walterboro, SC

National Provider Directory

National Provider Directory

Locations

1664 Ribaut Rd
Port Royal, SC 29935
Phone (843) 522-8466

Interoperability endpoints

  • Direct secure messaging: ajohnson@bec.intellechartdirect.net
  • Direct secure messaging: dkokinakis@bec.intellechartdirect.net
  • Direct secure messaging: jwebster@bec.intellechartdirect.net
  • Direct secure messaging: mnelson@bec.intellechartdirect.net
  • Direct secure messaging: nsopp@bec.intellechartdirect.net
  • Direct secure messaging: pdiana@bec.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1639398472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 RIBAUT RD",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299351708",
            "telephone_number": "843-522-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 RIBAUT RD",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299351708",
            "telephone_number": "843-522-8466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Okatie Center Blvd N Ste 103",
            "address_purpose": "LOCATION",
            "city": "Okatie",
            "state": "SC",
            "postal_code": "299093765",
            "country_code": "US",
            "telephone_number": "843-706-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BEAUFORT EYE CENTER P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "KOKINAKIS",
        "authorized_official_first_name": "DEMETRAJANE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "843-522-8466",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaufort Eye Clinic P A",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Beaufort Eye Clinic P A",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Port Royal, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.