Active NPI
Metrolina Eye Associates, PLLC
- Ophthalmology Physician
- Monroe, NC
National Provider Identifier
1700839305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- METROLINA EYE ASSOCIATES, PLLC
- Practice address
- 630 Comfort Lane
Suite E
Monroe, NC 28112-6493 - Phone
- (704) 289-5455
- Fax
- (704) 291-2207
- NPI assigned
- May 18, 2006
- Last updated
- Nov 26, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Nicolas M Tavares
- Title
- Chief Executive Officer
- Phone
- (704) 234-1934
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | NU | Primary |
Addresses
Primary practice location
630 Comfort Lane
Suite E
Monroe, NC 28112-6493
Mailing address
630 Comfort Lane
Suite E
Monroe, NC 28112-6493
Phone (704) 289-5455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89016P7 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, SC
Enrollment records 3
National Provider Directory
National Provider DirectoryLocations
2015 Randolph Rd
Charlotte, NC 28207
8816 University East Dr
Charlotte, NC 28213
Phone (980) 704-6670
6030 W Highway 74
Ste J
Indian Trail, NC 28079
4101 Campus Ridge Rd
Ste 200
Matthews, NC 28105
Phone (704) 234-1943
1410 E Franklin St
Monroe, NC 28112
Phone (704) 289-5455
630 Comfort Ln
Ste E
Monroe, NC 28112
Phone (704) 289-5455
6237 Carolina Commons Dr
Indian Land, SC 29707
Phone (704) 321-3376
Interoperability endpoints
- bmiles@metrolina.intellechartdirect.net
- cannunziata@metrolina.intellechartdirect.net
- cblotnick@metrolina.intellechartdirect.net
- cnicholson@metrolina.intellechartdirect.net
- ecalderon@metrolina.intellechartdirect.net
- imac@metrolina.intellechartdirect.net
- kcao@metrolina.intellechartdirect.net
- kdunkle@metrolina.intellechartdirect.net
- kleone@metrolina.intellechartdirect.net
- kratliff@metrolina.intellechartdirect.net
- lpeterson@metrolina.intellechartdirect.net
- mangell@metrolina.intellechartdirect.net
- mcarpenter@metrolina.intellechartdirect.net
- sbhathela@metrolina.intellechartdirect.net
- slee@metrolina.intellechartdirect.net
- splihcik@metrolina.intellechartdirect.net
- sschorner@metrolina.intellechartdirect.net
- zshah@metrolina.intellechartdirect.net
Practitioners & affiliated clinicians
Practitioners 17
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Plastic Surgery Physician
- Matthews, NC
- NPI 1700809621
Ophthalmology, SC
-
- Optometrist
- Charlotte, NC
- NPI 1336107747
-
- Optometrist
- Rock Hill, SC
- NPI 1821218835
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1732579200000",
"number": "1700839305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 COMFORT LANE",
"address_2": "SUITE E",
"city": "MONROE",
"state": "NC",
"postal_code": "281126493",
"telephone_number": "704-289-5455",
"fax_number": "704-291-2207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 COMFORT LANE",
"address_2": "SUITE E",
"city": "MONROE",
"state": "NC",
"postal_code": "281126493",
"telephone_number": "704-289-5455",
"fax_number": "704-291-2207"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "METROLINA EYE ASSOCIATES, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-18",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A",
"authorized_official_last_name": "TAVARES",
"authorized_official_first_name": "NICOLAS",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "704-234-1934",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89016P7",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monroe, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.