Mary R Coello, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-002681 Issued in GA

Practice address

4166 Buford Hwy NE
Plaza Fiesta Mall Suite S6-T5
Atlanta, GA 30345-1081

Phone

(404) 855-3888

NPI assigned

Feb 6, 2012

Sex

Female

Sole proprietor

No

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

International American University at Puerto Rico - School of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Optica Latina, LLC

  • Optometrist
  • Lilburn, GA
  • NPI 1992042972
  Medicare reassignment

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

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1679845739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 TRAVELERS TRL NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442870",
            "telephone_number": "770-815-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4166 BUFORD HWY NE",
            "address_2": "PLAZA FIESTA MALL SUITE S6-T5",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303451081",
            "telephone_number": "404-855-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COELLO",
        "first_name": "MARY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-06",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT-002681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shuntae Cody
• Choyce Stevens Coe, CPNP
• Elizabeth Coe
• Katherine Jean Coe, PA-C
• Marco R Coelho, OTR/L
• Sarah Marie Cofelice, M.A., BCBA
• Sarah Katie Dupree Coffee, PHARM.D.
• Mary Virginia Coffman, MS, CNS, LDN, LN
• Cantrella V Cofield, LMT
• Cherry Celeste Coggin, D.M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; 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.