Individual provider Active NPI

Herman Anthony Kwong, O.D.

  • Corneal and Contact Management Optometrist
  • Snellville, GA
National Provider Identifier
1689766529
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
1934 Issued in GA
Practice address
1520 Scenic Hwy N
Snellville, GA 30078-2130
Phone
(770) 979-2198
Fax
(770) 979-8382
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 1934 GA Primary

Addresses

Primary practice location

1520 Scenic Hwy N
Snellville, GA 30078-2130

Mailing address

1520 Scenic Hwy N
Snellville, GA 30078-2130
Phone (770) 979-2198

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061113000284 GA Practitioner - Optometry 0345248050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1520 Scenic Hwy N
Snellville, GA 30078-2130
Phone (770) 979-2198

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1934GAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Eyecare Professionals Corneal and Contact Management CurrentSince Oct 3, 2006 Accepting new patients

Locations

1520 Scenic Hwy N
Snellville, GA 30078
Phone (770) 979-2198

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1689766529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 SCENIC HWY N",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782130",
            "telephone_number": "770-979-2198",
            "fax_number": "770-979-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SCENIC HWY N",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782130",
            "telephone_number": "770-979-2198",
            "fax_number": "770-979-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWONG",
        "first_name": "HERMAN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "GA",
            "license": "1934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.