Xiaowen Pan

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003433 Issued in GA

Practice address

2061 Beverly Rd
Gainesville, GA 30501-2034

Phone

(770) 532-4444

NPI assigned

Jul 7, 2022

Last updated

Jul 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Optometry

Education

Southern College of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gainesville Eye Associates LLCGroup PAC ID 2860486438, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: xpan@esp.intellechartdirect.net

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.

• Gainesville Eye Associates LLC

  • Ophthalmology Physician
  • Gainesville, GA
  • NPI 1285617647

  Optometrist

  Medicare reassignment Care Compare group NPD
• Gainesville Eye Associates LLC

  dba North Georgia Eye Associates

  • Ophthalmology Physician
  • Braselton, GA
  • NPI 1821875774

  Optometrist

  NPD

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1679206601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 FALCON CREEK DR",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 BEVERLY RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012034",
            "telephone_number": "770-532-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "XIAOWEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Victoria Page, LPC
• Jennifer Palazzo, MPT
• Tessa Palisoc
• Hannah Grace Palmer, MA
• Kama Ann Palmer, RN, IBCLC
• Amir Kauveh Panah
• Laura Davis Pancake, MS,PT
• James Allan Panter, MD
• Marett Anne Panter, AGACNP-BC
• Theresa M Panter, APRN FNP-C

• Optometrist in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.