Individual provider Active NPI

Deepa Mishra

  • Optometrist
  • Dothan, AL
National Provider Identifier
1639844848
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-E87-TA-C22 Issued in AL
Practice address
2826 Ross Clark Cir Ste 102
Dothan, AL 36301-2017
Phone
(334) 793-2633
NPI assigned
Aug 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-E87-TA-C22 AL Primary

Addresses

Primary practice location

2826 Ross Clark Cir Ste 102
Dothan, AL 36301-2017

Mailing address

2800 Ross Clark Cir
Dothan, AL 36301-2040
Phone (334) 793-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20210820000868 AL Practitioner - Optometry 5395140941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Partners PCGroup PAC ID 8123016334, 31 clinicians

Practice addresses (Care Compare)

2826 Ross Clark Cir
Suite 102
Dothan, AL 36301-2017
Phone (334) 793-2633

Merit-based Incentive Payment System (MIPS)

Final score
84.59 of 100Reported as group
Quality
87.13
Promoting interoperability
95
Improvement activities
40
Cost
65.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Partners PC CurrentSince Aug 16, 2021 Accepting new patients
Eye Partners, PC Optometrist CurrentSince Aug 16, 2021 Accepting new patients
Eye Partners PC Optometrist Current Accepting new patients

Locations

2800 Ross Clark Cir
Ste 1
Dothan, AL 36301

2826 Ross Clark Cir
Ste 102
Dothan, AL 36301
Phone (334) 793-2633

2800 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-3411

151 W Main St
Dothan, AL 36301
Phone (334) 793-2633

Interoperability endpoints

  • Direct secure messaging: deepa.mishra.p1@direct.ecs.nextgenshare.com

Organizations & group practices 3

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": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639844848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012040",
            "telephone_number": "334-793-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2826 ROSS CLARK CIR STE 102",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012017",
            "telephone_number": "334-793-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHRA",
        "first_name": "DEEPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-E87-TA-C22",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.