Randy A Birt, OD
Individual provider Active NPI Optometrist · Bristol, VA
NPI 1649240656 · NPPES record last updated Aug 7, 2014
Key facts
- NPI
- 1649240656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 06275TG (TX)
- Practice address
- 1701 Euclid Ave
Bristol, VA 24201-3700 - Phone
- (276) 466-4227
- Fax
- (276) 466-3937
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Regional Eye Center PC
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 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171219000266 | TN | Practitioner - Optometry | 4981842895 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3424 | TN | MD | Chiropractor |
| 06275TG | TX | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Regional Eye Center, P.C. | Current |
Accepting new patients | |
| Regional Eye Center, PC | Current |
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
- randy.birtod.p1@direct.regionaleye.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 06275TG | TX | Yes |
Addresses
Primary practice location
1701 Euclid Ave
Bristol, VA 24201-3700
Mailing address
1701 Euclid Ave
Bristol, VA 24201-3700
Phone (276) 466-4227
Other providers in Bristol, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.