Organization Active NPI

Commerce Family Eyecare

  • Optometrist
  • Commerce, GA
National Provider Identifier
1639916133
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
COMMERCE FAMILY EYECARE
Practice address
1871 N Elm St
Commerce, GA 30529-2349
Phone
(706) 981-1122
Fax
(706) 659-3541
NPI assigned
Jul 11, 2024
Last updated
Jul 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Authorized official

Name
Umar IshaqueNPI 1649366287
Title
Owner
Phone
(706) 981-1122

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
Optometrist 152W00000X Primary

Addresses

Primary practice location

1871 N Elm St
Commerce, GA 30529-2349

Mailing address

1871 N Elm St
Commerce, GA 30529-2349
Phone (706) 981-1122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250130000221 GA Part B Supplier - Clinic/Group Practice 1052840410 Receives reassigned benefits from 3 practitioners
Practice locations: Commerce, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1639916133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 N ELM ST",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305292349",
            "telephone_number": "706-981-1122",
            "fax_number": "706-659-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1871 N ELM ST",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305292349",
            "telephone_number": "706-981-1122",
            "fax_number": "706-659-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMERCE FAMILY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "ISHAQUE",
        "authorized_official_first_name": "UMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-981-1122"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.