Individual provider Active NPI

David B Pratt, O.D.

  • Optometrist
  • Lexington, SC
National Provider Identifier
1679679575
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1444 Issued in SC
Practice address
1780 S Lake Dr
Lexington, SC 29073-8102
Phone
(803) 356-1414
Fax
(803) 356-0515
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1444 SC Primary

Addresses

Primary practice location

1780 S Lake Dr
Lexington, SC 29073-8102

Mailing address

116 Pink Camellia LN
Lexington, SC 29072-6507
Phone (803) 397-6255

Other identifiers 1

IdentifierTypeStateIssuer
D14447MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20080130000166 SC Practitioner - Optometry 8123100120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1780 S Lake Dr
Lexington, SC 29073-8102
Phone (803) 356-1414

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1444SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Sight Eyecare Inc Optometrist CurrentSince Sep 19, 2007 Accepting new patients

Locations

1780 S Lake Dr
Lexington, SC 29073
Phone (803) 356-1414

Organizations & group practices 1

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1679679575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 PINK CAMELLIA LN",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290726507",
            "telephone_number": "803-397-6255",
            "fax_number": "803-356-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 S LAKE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290738102",
            "telephone_number": "803-356-1414",
            "fax_number": "803-356-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D14447",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

Verify at the official NPI Registry.