Individual provider Active NPI

Randy A Birt, OD

  • Optometrist
  • Bristol, VA
National Provider Identifier
1649240656
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
06275TG Issued in TX
Practice address
1701 Euclid Ave
Bristol, VA 24201-3700
Phone
(276) 466-4227
Fax
(276) 466-3937
NPI assigned
Jan 23, 2006
Last updated
Aug 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 06275TG TX Primary

Addresses

Primary practice location

1701 Euclid Ave
Bristol, VA 24201-3700

Mailing address

1701 Euclid Ave
Bristol, VA 24201-3700
Phone (276) 466-4227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20171219000266 TN Practitioner - Optometry 4981842895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Eye Center PCGroup PAC ID 4284604596, 6 clinicians

Practice addresses (Care Compare)

135 W Ravine Rd
Suite 2 C
Kingsport, TN 37660-3847
Phone (423) 246-7372

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06275TGTXMDOptometrist
3424TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Regional Eye Center, P.C. CurrentSince Jan 1, 2018 Accepting new patients
Regional Eye Center, PC CurrentSince Jan 1, 2018 Accepting new patients

Locations

135 W Ravine Rd
Ste 2-C
Kingsport, TN 37660
Phone (423) 246-7372

135 W Ravine Rd
Ste 3
Kingsport, TN 37660

Interoperability endpoints

  • Direct secure messaging: randy.birtod.p1@direct.regionaleye.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1649240656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 EUCLID AVE",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242013700",
            "telephone_number": "276-466-4227",
            "fax_number": "276-466-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 EUCLID AVE",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242013700",
            "telephone_number": "276-466-4227",
            "fax_number": "276-466-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRT",
        "first_name": "RANDY",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "06275TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, VA

Sources for this page

Verify at the official NPI Registry.